Individual
ERIC MAX BORTNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
789 HOWARD AVE # FMP309, NEW HAVEN, CT 06519-1304
(203) 785-7671
Mailing address
789 HOWARD AVE # FMP309, NEW HAVEN, CT 06519-1304
(203) 785-7671
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
77347
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2016
Last updated
09/24/2024
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