Basic Information
| Provider Information | |||||||||
| NPI: | 1073621371 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OTTENIO | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | MARIA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 150 55TH ST | ||||||||
| Address2: | STATION 21 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112202508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186308827 | ||||||||
| FaxNumber: | 7184925090 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 55TH ST | ||||||||
| Address2: | STATION 21 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112202508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186308827 | ||||||||
| FaxNumber: | 7184925090 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2006 | ||||||||
| LastUpdateDate: | 12/18/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 048660-1 | NY | Y | Dental Providers | Dentist |
No ID Information.