Healthcare Provider Details

I. General information

NPI: 1487182820
Provider Name (Legal Business Name): AMELIE BOTTEX DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E MAIN ST
MOUNT KISCO NY
10549-3477
US

IV. Provider business mailing address

400 E MAIN ST
MOUNT KISCO NY
10549-3477
US

V. Phone/Fax

Practice location:
  • Phone: 914-666-1200
  • Fax:
Mailing address:
  • Phone: 914-666-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOT018034
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: