Jaquilo D Bottini

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

26NR16772500 Issued in NJ

Practice address

764 Palisade Ave Ste 2B
Teaneck, NJ 07666-3129

Phone

(973) 955-9118

Fax

(201) 537-5478

NPI assigned

Oct 20, 2017

Last updated

Nov 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Private Aid Contractor, LLC

  • Home Health Registered Nurse
  • Teaneck, NJ
  • NPI 1538754403
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1003327727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 PALISADE AVE STE 2B",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663129",
            "telephone_number": "973-955-9118",
            "fax_number": "201-357-5478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 PALISADE AVE STE 2B",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663129",
            "telephone_number": "973-955-9118",
            "fax_number": "201-537-5478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTINI",
        "first_name": "JAQUILO",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2022-11-14",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NJ",
            "license": "26NH11329800",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NJ",
            "license": "26NR16772500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bolsters and Balls Occupational Therapy
• Olivia Bondarsky
• Christina May Bongalos Salazar, PA-C
• Ohenewaa A Bonsu
• Krista Bonura
• Jessica Rose Botwinick, OTR/L
• Natalie Bou
• Leah Bouskila
• Geraldine Theresa Bowe, APN,C
• BR3 Health & Performance L.L.C.

• Home Health Registered Nurse in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Home Health Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.