Botta, Marivic Dayrit

Botta, Marivic Dayrit is an individual health care provider with primary practice located at 15 Corporate Dr , Trumbull CT 06611-1351. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Botta, Marivic Dayrit can be contacted via phone (203) 452-8322.

Contact Information

Primary practice address
15 Corporate Dr Trumbull CT 06611-1351
Phone: (203) 452-8322
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 045299 Connecticut
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 045299 Connecticut

Profile Details

NPI number 1013055102
LBN Legal business name Botta, Marivic Dayrit
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2007
Last updated Jun 18th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013055102 NPPES
Connecticut Other 061319954 TAX ID#

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