Individual
DR. MICHELLE L BOTSACOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1562 LEMOINE AVE STE 3, FORT LEE, NJ 07024-5652
(201) 461-7595
Mailing address
30 EMERSON ST, RIDGEFIELD PARK, NJ 07660-2017
(201) 468-2148
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00716500
NJ
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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