| Joseph Botta Md & Associates Llc | |
|
150 Ware Rd Dayville CT 06241-1126 | |
| (860) 779-5093 | |
| (860) 779-5095 |
| Full Name | Joseph Botta Md & Associates Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 150 Ware Rd, Dayville, Connecticut |
| Authorized Official Name and Position | Joseph J Botta (PHYSICIAN/OWNER) |
| Authorized Official Contact | 8607795093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph Botta Md & Associates Llc 150 Ware Rd Dayville CT 06241-1126 Ph: (860) 779-5093 | Joseph Botta Md & Associates Llc 150 Ware Rd Dayville CT 06241-1126 Ph: (860) 779-5093 |
| NPI Number | 1659511046 |
|---|---|
| Provider Enumeration Date | 02/25/2009 |
| Last Update Date | 02/25/2009 |
| Medicare PECOS PAC ID | 2365508306 |
|---|---|
| Medicare Enrollment ID | O20090227000142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659511046 | NPI | - | NPPES |
| 010040605CT01 | Other | CT | ANTHEM BCBS |
| 2V2749 | Other | CT | HEALTHNET |
| 1406059 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 040605 (Connecticut) | Primary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | 040605 (Connecticut) | Secondary |
| Provider Name | David L Candow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457365363 PECOS PAC ID: 8224920848 Enrollment ID: I20040329000274 |
| Provider Name | Joseph J Botta |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1831105360 PECOS PAC ID: 6709890908 Enrollment ID: I20060126000611 |
| Provider Name | Ronald W Klare |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760498539 PECOS PAC ID: 0941350961 Enrollment ID: I20090615000096 |
Medical Center Of Northeast Connecticut Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 612 Hartford Pike, Dayville, CT 06241 Phone: 860-779-0284 Fax: 860-779-0386 | |
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