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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | ALEXANDER VLADIMIROVICH OTELLIN · Alexander Otellin · OTELLIN ALEXANDER VLADIMIROVICH | [sources] | |||
| Birth date | [sources] | ||||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Alexander | [sources] | |||
| Last name | Otellin | [sources] | |||
| Middle name | VLADIMIROVICH | [sources] | |||
| NPI | 1740302066 | [sources] | |||
| Sector | Psychiatry | [sources] | |||
| Unique Entity ID | Y18LKHF6UJ68 | [sources] | |||
| Position | PSYCHIATRY (PHYSICIAN (MD, DO)) | [sources] | |||
| Address | 401 Division Street, Suite 307, South Charleston, WV 25309 · OTISVILLE, NY 10963 · P O BOX 1000, OTISVILLE, NY 10963 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers deemed ineligible to participate in New York State's Medicaid program.
United States · OMIG
Medicaid providers sanctioned in West Virginia's Medicaid program.
United States · MMIS
People and companies excluded from Federally funded health care programs
United States · OIG
A database of suppliers who have been excluded from participating in US federal procurement.
United States · GSA
us-medwv-9ff263dbf9eb4281bb69325eab7d4114906dc457 · us-medny-038b46538b79837c64769ea8a8805cd39679faec · us-fed-excl-alexander-vladimirovich-otellin-10963-otisvilleFor experts: raw data explorer
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| Address | ||
|---|---|---|
| Full address | Country | |
| 401 Division Street, Suite 307, South Charleston, WV 25309 | United States | |
| United States | New York State Office of the Medicaid Inspector General | - | - |
| United States | Medicaid Management Information System | - | - |
| United States | Department of Health and Human Services Office of Inspector General | List of Excluded Individuals/Entities (LEIE) | - |