Provider Demographics
NPI:1750630729
Name:BOTT-TOMARCHIO, CYNTHIA
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:BOTT-TOMARCHIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1453 TRENTON HARBOURTON RD
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-4011
Mailing Address - Country:US
Mailing Address - Phone:609-203-3597
Mailing Address - Fax:267-629-3261
Practice Address - Street 1:1453 TRENTON HARBOURTON RD
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-4011
Practice Address - Country:US
Practice Address - Phone:609-203-3597
Practice Address - Fax:267-629-3261
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst