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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

AGEDI NICHOLSON BOTO, M.D./PH.D.

Active Sole Proprietor

AGEDI NICHOLSON BOTO, M.D./PH.D. is a Anatomic Pathology healthcare provider located in BRIDGEPORT, Connecticut. NPI 1568729077 is currently active in the NPPES registry. Verify at CMS.

Anatomic Pathology · BRIDGEPORT, CT

Registration Details

NPI Number
1568729077
Provider Type
Individual
Gender
Male
NPI Issued
Apr 20, 2012 (14.173739011605 yrs)
Last Updated
Mar 11, 2019
License
55202 (CT)
Sole Proprietor
Yes

Practice Information

Address
2800 MAIN ST
BRIDGEPORT, CT, 066064201
Browse CT providers · Browse ZIP 06606
Phone
4752105032
Fax
4752105034
Primary Specialty
Anatomic Pathology
207ZP0101X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.