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Organization

JOSEPH BOTTA MD & ASSOCIATES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH J BOTTA M.D. (PHYSICIAN/OWNER)
(860) 779-5093
Entity
Organization

Contact information

Practice address
150 WARE RD, DAYVILLE, CT 06241-1126
(860) 779-5093
(860) 779-5095
Mailing address
150 WARE RD, DAYVILLE, CT 06241-1126
(860) 779-5093
(860) 779-5095

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
040605
CT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
040605
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010040605CT01
ANTHEM BCBS
CT
05
1406059
CT
01
2V2749
HEALTHNET
CT
Enumeration date
02/25/2009
Last updated
02/25/2009
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