# PROFESSIONAL SPORTS MEDICINE ASSOCIATES L.L.C

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043457211
- **Authorized official:** DR. THOMAS BOTTIGLIERI D.O. (PRESIDENT)
- **Authorized official phone:** (201) 569-0010

## Contact information

- **Practice address:** 67 BROADWAY, ELMWOOD PARK, NJ 07407-1836
- **Practice address phone:** (201) 569-0010
- **Practice address fax:** (201) 794-8411
- **Mailing address:** PO BOX 70176, STATEN ISLAND, NY 10307-0176
- **Mailing address phone:** (201) 569-0010
- **Mailing address fax:** (201) 569-0080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2009
- **Last updated:** 02/11/2013