Provider Demographics
NPI:1073720165
Name:BOTTINO, WILLIAM ANTHONY JR (DPT)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ANTHONY
Last Name:BOTTINO
Suffix:JR
Gender:M
Credentials:DPT
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Mailing Address - Street 1:315 WOOTTON ST
Mailing Address - Street 2:UNITS I AND J
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-1939
Mailing Address - Country:US
Mailing Address - Phone:973-794-6040
Mailing Address - Fax:973-794-6041
Practice Address - Street 1:315 WOOTTON ST
Practice Address - Street 2:UNITS I AND J
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005-1939
Practice Address - Country:US
Practice Address - Phone:973-794-6040
Practice Address - Fax:973-794-6041
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2020-10-23
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Provider Licenses
StateLicense IDTaxonomies
NJ40QA01211100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist