Provider Demographics
NPI:1053417535
Name:VOTTO, AMANDA FAMOLARE (PA-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:FAMOLARE
Last Name:VOTTO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1062 BARNES RD
Mailing Address - Street 2:STE 300
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2576
Mailing Address - Country:US
Mailing Address - Phone:860-525-1532
Mailing Address - Fax:203-265-0356
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:BRIGHMAN AND WOMEN'S HOSPITAL- HOSPITALIST SERVICE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-278-0055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAP1912363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant