Provider Demographics
NPI:1255374328
Name:OTTON, JAMES PATRICK (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PATRICK
Last Name:OTTON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7611 AQUATIC DR
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-2016
Mailing Address - Country:US
Mailing Address - Phone:718-474-3984
Mailing Address - Fax:718-945-7785
Practice Address - Street 1:224 W 29TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5204
Practice Address - Country:US
Practice Address - Phone:212-643-9110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist