# PURNIMA M. KOTHARI, PHYSICIAN, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710193024
- **Authorized official:** DR. PURNIMA M KOTHARI (PRESIDENT)
- **Authorized official phone:** (516) 735-1116

## Contact information

- **Practice address:** 54 HEATHER LN, LEVITTOWN, NY 11756-3334
- **Practice address phone:** (516) 735-1116
- **Mailing address:** 54 HEATHER LN, LEVITTOWN, NY 11756-3334

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 146056 | NY | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 204375 | NY | — |

## Other

- **Enumeration date:** 05/15/2007
- **Last updated:** 01/25/2017