Individual provider Active NPI

Mark Christian Botti, PHARMD

  • Pharmacist
  • Newburgh, NY
National Provider Identifier
1790064434
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20-055935 Issued in NY
Practice address
1201 Route 300
Newburgh, NY 12550-5005
Phone
(845) 567-6093
NPI assigned
Aug 11, 2011
Last updated
Aug 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20-055935 NY Primary

Addresses

Primary practice location

1201 Route 300
Newburgh, NY 12550-5005

Mailing address

1201 Route 300
Newburgh, NY 12550-5005
Phone (845) 567-6093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
20-055935NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1790064434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 ROUTE 300",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505005",
            "telephone_number": "845-567-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 ROUTE 300",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505005",
            "telephone_number": "845-567-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTI",
        "first_name": "MARK",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "20-055935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.