Pablo Otero, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

561931 Issued in NY

Practice address

219 Pine St
Theresa, NY 13691-2103

Phone

(315) 628-4214

Fax

(315) 628-4214

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104993260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 PINE ST",
            "city": "THERESA",
            "state": "NY",
            "postal_code": "136912103",
            "telephone_number": "315-628-4214",
            "fax_number": "315-628-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 PINE ST",
            "city": "THERESA",
            "state": "NY",
            "postal_code": "136912103",
            "telephone_number": "315-628-4214",
            "fax_number": "315-628-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO",
        "first_name": "PABLO",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "561931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02171286",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellen Norma Denise Gill
• Kristina Green, M.A., CCC-SLP
• Kathleen Ann Hilyer, LPN
• Theresa Leeson, RN
• Rachel Beth Mason, LPN
• Amy Lynn Petrie, LPN
• Todd C Reed, LPN
• Chanelle Juanita Savage
• Amanda Leigh Smith, PA-C
• Sandra M Tejkl, LPN

• Registered Nurse in Theresa, NY
• Providers in Theresa, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.