Provider Demographics
NPI:1013244730
Name:BOTTI, ERIN (ANP-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BOTTI
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GRAND ST FL 3
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-291-0966
Mailing Address - Fax:845-291-9983
Practice Address - Street 1:1 HATFIELD LN STE 1B
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-6753
Practice Address - Country:US
Practice Address - Phone:845-291-0966
Practice Address - Fax:845-291-9983
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305177-1363LA2200X
NJ26NJ00357600363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health