Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 14679 | PR |
Y | 2084N0402X | Child Neurologist | 235604 | MA |
NPI | 1275520074 |
---|---|
Provider Name | Dr. Myrta Ines Otero |
First Address | Lawrence, MA 01843-1754 |
Second Address | Lawrence, MA 01843-1754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 04/03/2020 |