Provider Demographics
NPI:1184927915
Name:OTTINO, LOUIS EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:EDWARD
Last Name:OTTINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 KISCO AVE STE L
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-1417
Mailing Address - Country:US
Mailing Address - Phone:914-849-9972
Mailing Address - Fax:914-358-1213
Practice Address - Street 1:120 KISCO AVE STE L
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1417
Practice Address - Country:US
Practice Address - Phone:914-849-9972
Practice Address - Fax:914-358-1213
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10176111N00000X
NYX012200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor