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Victoria Angela Otterbeck

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Avenue, Staten Island, NY 10305

PECOS Enrollment

This provider is enrolled in PECOS as VICTORIA OTTERBECK.

Based on the most recent information from CMS, provider Victoria Angela Otterbeck is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1992765416
Provider Type
Individual
Full Name
Otterbeck, Victoria Angela
Title
Mrs.
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
3/27/2006
Last Updated
1/6/2016

Contact Information

Practice Location

475 Seaview Avenue, Staten Island, NY 10305

(718) 226-6210

(718) 226-1653

Mailing Location

475 Seaview Avenue, Staten Island, NY 10305

(718) 226-6210

(718) 226-1653

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 009474 New York

Victoria Angela Otterbeck

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Cusumano, Nicole Joann

Sommers, Stephanie

Marchese, Robert Vito

Guarnera, Grazia

Lantowski, Agnieszka

Jacob, Stacy

Lastella, Megan Marie

Castro, Cecilia R

Guadagno, Lynn Marie

Mendoza, Patricia Ann