Provider Demographics
NPI:1821795709
Name:DOTTIN, AISHA (RE)
Entity Type:Individual
Prefix:MS
First Name:AISHA
Middle Name:
Last Name:DOTTIN
Suffix:
Gender:F
Credentials:RE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 BOYLSTON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2863
Mailing Address - Country:US
Mailing Address - Phone:617-490-0110
Mailing Address - Fax:
Practice Address - Street 1:345 BOYLSTON ST STE 202
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-2863
Practice Address - Country:US
Practice Address - Phone:617-490-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician