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Organization
RESIDE HEALTH MEDICAL GROUP, PLLC
Active
Organization
RESIDE HEALTH MEDICAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOMAL KOTHARI MD (PHYSICIAN MEMBER)
(201) 503-4651
Entity
Organization
Contact information
Practice address
520 BROADWAY FL 4, NEW YORK, NY 10012-4436
(201) 503-4651
Mailing address
520 BROADWAY FL 4, NEW YORK, NY 10012-4436
(201) 503-4651
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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