Individual
DR. JOSEPH JOHN BOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24 S MAIN ST, PUTNAM, CT 06260-1906
(860) 315-9026
(860) 315-9142
Mailing address
24 S MAIN ST, PUTNAM, CT 06260-1906
(860) 315-9026
(860) 315-9142
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
08/01/2006
Last updated
07/22/2014
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