Otto, Russell R
Otto, Russell R is an individual health care provider with primary practice located at 201 Boston Post Rd , Waterford CT 06385. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Otto, Russell R can be contacted via phone (860) 442-0407.Contact Information
Primary practice address
201 Boston Post Rd
Waterford CT 06385
Phone: (860) 442-0407
Fax: (860) 444-2015
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 004505 | Connecticut |
Profile Details
| NPI number | 1346264215 |
|---|---|
| LBN Legal business name | Otto, Russell R |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2006 |
| Last updated | Oct 29th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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