Individual
JEAN A OTRAKJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
721 N BEERS ST, SUITE 1-F, HOLMDEL, NJ 07733-1518
(732) 888-9100
(732) 888-5515
Mailing address
721 N BEERS ST, SUITE 1-F, HOLMDEL, NJ 07733-1518
(732) 888-9100
(732) 888-5515
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
25MA04735600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3266206
—
NJ
Enumeration date
03/21/2006
Last updated
08/19/2010
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