Provider Demographics
NPI:1760030654
Name:OTT, KATLYN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATLYN
Middle Name:
Last Name:OTT
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 1:10 ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-2206
Mailing Address - Country:US
Mailing Address - Phone:412-335-6385
Mailing Address - Fax:
Practice Address - Street 1:324 HULTON RD
Practice Address - Street 2:
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-1917
Practice Address - Country:US
Practice Address - Phone:412-335-6385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist