MEDICARE: DR. MICHELLE L BOTSACOS OD

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	152W00000X	Optometrist	27OA00716500	NJ

General Provider Information

NPI Number	:	1861120610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE L BOTSACOS OD

Provider Business Mailing Address
First Line	:	30 EMERSON ST
Second Line	:
City	:	RIDGEFIELD PARK
State	:	NJ
Zip	:	07660-2017
Country	:	US
Telephone Number	:	201-468-2148
Fax Number	:

Provider Business Practice Location Address
First Line	:	1562 LEMOINE AVE STE 3
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5652
Country	:	US
Telephone Number	:	201-461-7595
Fax Number	:

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

Provider Enumeration Date	:	08/10/2022
Last Update Date	:	08/10/2022

Similar Medicare Providers

1922110923 — FORT LEE PHARMACY & SURGICAL INC
Practice Location Address:

1562 LEMOINE AVE
FORT LEE, NJ
07024-5652

Practice Phone: 201-346-9202
Practice Fax: 201-346-9212

1770093544 — FORT LEE PHARMACY & SURGICAL INC
Practice Location Address:

1562 LEMOINE AVE
FORT LEE, NJ
07024-5652

Practice Phone: 201-346-9202
Practice Fax:

1841085560 — CATHERINE BULILAN
Practice Location Address:

4475 TREASURE COVE DR
FORT LAUDERDALE, FL
33312-5652

Practice Phone: 727-229-0107
Practice Fax:

1477405389 — SAE AHM HONG
Practice Location Address:

1681 FLETCHER AVE
FORT LEE, NJ
07024

Practice Phone: 201-944-1214
Practice Fax:

1699627356 — KALEIDOSCOPIC MINDS
Practice Location Address:

100 OLD PALISADE RD APT 3510
FORT LEE, NJ
07024-7027

Practice Phone: 917-426-3587
Practice Fax:

1811525538 — ALEX FU DO
Practice Location Address:

301 BRIDGE PLZ N STE 300
FORT LEE, NJ
07024-5059

Practice Phone: 848-308-4690
Practice Fax: 848-308-4691

Directions to “ DR. MICHELLE L BOTSACOS OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.