Individual
LARA G KOTHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6363
Mailing address
10 ROBERTS AVE, NEWTON, MA 02460-1516
(617) 630-0163
(617) 630-0163
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
219716
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041189
—
MA
Enumeration date
03/10/2006
Last updated
07/20/2009
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