Doctor Name: | DR. RAJESH S KOTHARI |
NPI Number: | 1659363174 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | 25MB06966000 |
Business Practice Address: | 495 N 13th St Newark, NJ - 071071317 |
Business Phone Number: | 9732681400 |
Business Fax Number: | |
Mailing Address: | 66 W Gilbert St, Suite 100 TINTON FALLS |
State: | NJ |
Postal Code: | 077014918 |
Phone Number: | 7322120060 |
Fax Number: | 7322120061 |
NPI Enumeration Date: | 08/19/2005 |
NPI Last Update Date: | 06/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25MB06966000 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |