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General NPI Number Information
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NPI Number | 1154323897
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Entity Type | Organization
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Legal Business Name | JOSEPH MOTTA MD PC
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 01/21/2011
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Provider Practice Location Address
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Address Line | 1200 SOUTH AVE SUITE 301
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3413
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Country | US
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Telephone | 718-370-1400
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Fax | 718-370-9290
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Provider Business Mailing Address
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Address Line | 1200 SOUTH AVE SUITE 301
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3413
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Country | US
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Telephone | 718-370-1400
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Fax | 718-370-9290
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH MOTTA
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Credential | MD
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Telephone | 718-370-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 194905
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 194905
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License Number State | NY
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