Richard Botting, R.PH.
Individual provider Active NPI Pharmacist · Massena, NY
NPI 1265614408 · NPPES record last updated Nov 29, 2007
Key facts
- NPI
- 1265614408
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 026191 (NY)
- Practice address
- 300 Main St
Massena, NY 13662-1901 - Phone
- (315) 764-0559
- NPI assigned
- Nov 29, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026191 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KPH Healthcare Services, Inc. | Past | Accepting new patients | |
| KPH Healthcare Services, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 026191 | NY | Yes |
Addresses
Primary practice location
300 Main St
Massena, NY 13662-1901
Mailing address
300 Main St
Massena, NY 13662-1901
Phone (315) 764-0559
Other providers in Massena, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.