Individual
MISS NICOLE BOTTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
319 LONGWOOD AVE, BOSTON, MA 02115
(617) 355-3501
(617) 730-0682
Mailing address
89 FAIRFAX CT, MADISON, NJ 07940-1150
(201) 739-2402
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00383500
NJ
363AS0400X
Surgical Physician Assistant
PA4441
MA
Other
Enumeration date
07/26/2012
Last updated
06/19/2018
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