Provider Demographics
NPI:1356316020
Name:ASPEN, OTTER QUAKING (MD)
Entity Type:Individual
Prefix:DR
First Name:OTTER
Middle Name:QUAKING
Last Name:ASPEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:35 GREEN POND RD
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-2052
Mailing Address - Country:US
Mailing Address - Phone:973-625-0600
Mailing Address - Fax:973-625-3434
Practice Address - Street 1:35 GREEN POND RD
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-2052
Practice Address - Country:US
Practice Address - Phone:973-625-0600
Practice Address - Fax:973-625-3434
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225819207N00000X
NJ25MA08902100207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology