Provider Demographics
NPI:1629753116
Name:BARTOLOTTA, PAMELA IRENE (RADIOGRAPHER)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:IRENE
Last Name:BARTOLOTTA
Suffix:
Gender:F
Credentials:RADIOGRAPHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CARPENTER AVE
Mailing Address - Street 2:
Mailing Address - City:NIANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06357-3046
Mailing Address - Country:US
Mailing Address - Phone:860-235-2367
Mailing Address - Fax:
Practice Address - Street 1:4 CARPENTER AVE
Practice Address - Street 2:
Practice Address - City:NIANTIC
Practice Address - State:CT
Practice Address - Zip Code:06357-3046
Practice Address - Country:US
Practice Address - Phone:860-235-2367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0007792085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology