Doctor Name: | DR. ROBERT WILLIAM BOTTINELLI |
NPI Number: | 1225060585 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PS002794-L |
Business Practice Address: | 102 S Coolidge Ave Margate City, NJ - 084022205 |
Business Phone Number: | 6098233560 |
Business Fax Number: | |
Mailing Address: | 102 S Coolidge Ave, MARGATE CITY |
State: | NJ |
Postal Code: | 084022205 |
Phone Number: | 6098233560 |
Fax Number: | |
NPI Enumeration Date: | 07/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS002794-L |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |