Botticelli, Jacquelyn Anne

Botticelli, Jacquelyn Anne is an individual health care provider with primary practice located at 60 Innsbruck Dr , Buffalo NY 14227-2735. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Botticelli, Jacquelyn Anne can be contacted via phone (716) 668-7051.

Contact Information

Primary practice address
60 Innsbruck Dr Buffalo NY 14227-2735
Phone: (716) 668-7051
Fax: (716) 669-7069
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 30-304311 New York

Profile Details

NPI number 1356349740
LBN Legal business name Botticelli, Jacquelyn Anne
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Mar 11th, 2009 - about 15 years ago

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 1356349740 NPPES
New York Other 9515444 INDEPENDENT HEALTH
New York MEDICAID 03061112 INDEPENDENT HEALTH

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