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General NPI Number Information
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NPI Number | 1609920842
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Entity Type | Individual
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Provider Name | ANDREI BOTEA M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 150 BERGEN ST
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City | NEWARK
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State | NJ
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Zip | 07103-2496
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Country | US
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Telephone | 973-972-5254
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Fax | 973-972-4172
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Provider Business Mailing Address
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Address Line | 30 BERGEN ST ADMC 12 1205
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City | NEWARK
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State | NJ
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Zip | 07107-3000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 25MA07151000
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License Number State | NJ
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