Healthcare Provider Details

I. General information

NPI: 1891918587
Provider Name (Legal Business Name): PATRICIA BILLOTTI PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 FRANKLIN TPKE SUITE 1-8
WALDWICK NJ
07463-1851
US

IV. Provider business mailing address

18 POWDER HILL RD
SADDLE RIVER NJ
07458-3215
US

V. Phone/Fax

Practice location:
  • Phone: 201-447-0951
  • Fax:
Mailing address:
  • Phone: 201-447-0951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number26NC50112
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number000815
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: