Healthcare Provider Details

I. General information

NPI: 1568448314
Provider Name (Legal Business Name): LYNNE VALENCIA PERRY-BOTTINGER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LYNNE PERRY M.D.

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140A LOCKWOOD AVE
NEW ROCHELLE NY
10801-4920
US

IV. Provider business mailing address

140A LOCKWOOD AVENUE
NEW ROCHELLE NY
10801-4920
US

V. Phone/Fax

Practice location:
  • Phone: 914-576-7577
  • Fax: 914-576-7377
Mailing address:
  • Phone: 914-576-7577
  • Fax: 914-576-7377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number206637
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number206637
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: