Provider Demographics
NPI:1750666335
Name:OTTAVIO, CHRISTY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:
Last Name:OTTAVIO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08322-2348
Mailing Address - Country:US
Mailing Address - Phone:856-313-1155
Mailing Address - Fax:
Practice Address - Street 1:2119 CONCORD PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2906
Practice Address - Country:US
Practice Address - Phone:302-656-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003756183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist