MEDICARE: DR. MYLES EUGENE DOTTO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	MA33575	NJ

General Provider Information

NPI Number	:	1346215761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MYLES EUGENE DOTTO M.D.

Provider Business Mailing Address
First Line	:	680 KINDERKAMACK RD
Second Line	:
City	:	ORADELL
State	:	NJ
Zip	:	07649-1600
Country	:	US
Telephone Number	:	201-391-5443
Fax Number	:	201-391-8019

Provider Business Practice Location Address
First Line	:	680 KINDERKAMACK RD
Second Line	:
City	:	ORADELL
State	:	NJ
Zip	:	07649-1600
Country	:	US
Telephone Number	:	201-391-5443
Fax Number	:	201-391-8019

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2006
Last Update Date	:	02/17/2010

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