Provider Demographics
NPI:1457375941
Name:OTA, NANCY Y (DC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:Y
Last Name:OTA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NORTHERN BLVD
Mailing Address - Street 2:STE 10
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2328
Mailing Address - Country:US
Mailing Address - Phone:603-886-8900
Mailing Address - Fax:
Practice Address - Street 1:10 NORTHERN BLVD
Practice Address - Street 2:STE 10
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2328
Practice Address - Country:US
Practice Address - Phone:603-886-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH249-0696111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0502788YONH02OtherANTHEM BCBS
NHAA52905OtherHARVARD PILGRIM HEALTHCAR