Botta, Joseph John

Botta, Joseph John is an individual health care provider with primary practice located at 24 S Main St , Putnam CT 06260-1906. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Botta, Joseph John can be contacted via phone (860) 315-9026.

Contact Information

Primary practice address
24 S Main St Putnam CT 06260-1906
Fax: (860) 315-9142
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 040605 Connecticut
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 040605 Connecticut

Profile Details

NPI number 1831105360
LBN Legal business name Botta, Joseph John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Jul 22nd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831105360 NPPES
Connecticut Other 010040605CT01 ANTHEM BCBS
Connecticut MEDICAID 1406059 ANTHEM BCBS
Connecticut Other 2V2749 ANTHEM BCBS

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