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NPI Code Detail

MEDICARE: KRISTEN BOTTACHIARI

MEDICARE: KRISTEN BOTTACHIARI
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
1225X00000XOccupational TherapistOT01204RI

General Provider Information

NPI Number : 1740603737
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN BOTTACHIARI
Provider Business Mailing Address
First Line : 5 THAMES ST
Second Line :
City : BRISTOL
State : RI
Zip : 02809-1814
Country : US
Telephone Number : 774-291-9413
Fax Number :
Provider Business Practice Location Address
First Line : 642 METACOM AVE
Second Line :
City : WARREN
State : RI
Zip : 02885-2350
Country : US
Telephone Number : 401-245-2860
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2014
Last Update Date : 01/27/2014

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Directions to “ KRISTEN BOTTACHIARI ” Practice Location

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