Provider Demographics
NPI:1225061518
Name:BOTWINICK, NELSON G (MD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:G
Last Name:BOTWINICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 WILLIAM ST
Mailing Address - Street 2:8 FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-2612
Mailing Address - Country:US
Mailing Address - Phone:212-312-5598
Mailing Address - Fax:212-312-5591
Practice Address - Street 1:170 WILLIAM ST
Practice Address - Street 2:8 FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-2612
Practice Address - Country:US
Practice Address - Phone:212-312-5598
Practice Address - Fax:212-312-5591
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150861-1207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY72D341Medicare PIN
NYA63994Medicare UPIN