Dr. Nicole Otto
Family Doctor - Sports Medicine
3535 Market St Suite 100
Philadelphia
, Pennsylvania 19104-3309
Dr. Nicole Otto
Family Doctor - Sports Medicine
3535 Market St Suite 100
Philadelphia
, Pennsylvania 19104-3309
(610) 328-2892
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Nicole Otto
- 213 Dickinson Ave
- Swarthmore, PA
- Zip : 19081-1630
- Phone : (610) 328-2892
Second Address
- Dr. Nicole Otto
- 3535 Market St Suite 100
- Philadelphia, PA
- Zip : 19104-3309
- Fax : (215) 746-1032
- Phone : (215) 746-3535
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | MD425787 | PA |
National Provider Identifier
| NPI | 1306915335 |
|---|---|
| Provider Name | Dr. Nicole Otto |
| First Address | Swarthmore, PA 19081-1630 |
| Second Address | Philadelphia, PA 19104-3309 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/11/2006 |
| Last Update Date | 09/09/2009 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.