Healthcare Provider Details

I. General information

NPI: 1548468333
Provider Name (Legal Business Name): MAUREEN BOTTIGLIERI RN,CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VALLEY HEALTH PLZ
PARAMUS NJ
07652-3628
US

IV. Provider business mailing address

121 CLEVELAND AVE
HASBROUCK HEIGHTS NJ
07604-1020
US

V. Phone/Fax

Practice location:
  • Phone: 201-634-5359
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number42-US-42033372
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: