Individual
JULIAN SEBASTIAN BOTTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1830 E MONUMENT ST # MD21287, SUITE 6‐100, BALTIMORE, MD 21287-0020
(201) 645-3735
Mailing address
1310 DICKERSON RD, TEANECK, NJ 07666-2816
(201) 645-3735
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D0090080
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2017
Last updated
10/19/2021
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