Provider Demographics
NPI:1144963547
Name:BOTKIN, JOSHUA (DO)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:BOTKIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-1631
Mailing Address - Country:US
Mailing Address - Phone:585-275-2100
Mailing Address - Fax:
Practice Address - Street 1:STRONG MEMORIAL HOSPITAL 601 ELMWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-1631
Practice Address - Country:US
Practice Address - Phone:585-343-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY324841207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program