Provider Demographics
NPI:1609186675
Name:BACOTTI, MICHAEL J (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:BACOTTI
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Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:246 PLEASANT ST
Mailing Address - Street 2:SUITE G2
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-224-3388
Mailing Address - Fax:603-225-3557
Practice Address - Street 1:246 PLEASANT ST
Practice Address - Street 2:SUITE G2
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-224-3388
Practice Address - Fax:603-225-3557
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2016-12-28
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Provider Licenses
StateLicense IDTaxonomies
NH1066363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical