Individual
DR. MARY TERESA BOTELHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 562-1394
Mailing address
91 CANNON BLVD, STATEN ISLAND, NY 10306-2811
(718) 873-4761
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008583
NY
Other
Enumeration date
06/30/2017
Last updated
08/09/2021
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