Healthcare Provider Details

I. General information

NPI: 1346215761
Provider Name (Legal Business Name): MYLES EUGENE DOTTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 KINDERKAMACK RD
ORADELL NJ
07649-1600
US

IV. Provider business mailing address

680 KINDERKAMACK RD
ORADELL NJ
07649-1600
US

V. Phone/Fax

Practice location:
  • Phone: 201-391-5443
  • Fax: 201-391-8019
Mailing address:
  • Phone: 201-391-5443
  • Fax: 201-391-8019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMA33575
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: