Individual
AGEDI NICHOLSON BOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D./PH.D.
Contact information
Practice address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
(475) 210-5032
(475) 210-5034
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-2259
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
55202
CT
Other
Enumeration date
04/20/2012
Last updated
03/11/2019
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