Provider Demographics
NPI:1578795050
Name:OTTAVIANO, JANET LEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LEE
Last Name:OTTAVIANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10740 ROUTE 240
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:14171-9796
Mailing Address - Country:US
Mailing Address - Phone:716-942-3980
Mailing Address - Fax:
Practice Address - Street 1:10740 ROUTE 240
Practice Address - Street 2:
Practice Address - City:WEST VALLEY
Practice Address - State:NY
Practice Address - Zip Code:14171-9796
Practice Address - Country:US
Practice Address - Phone:716-942-3980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY386997-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse