Organization
NEW JERSEY PROCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINNARI ASHOK KOTHARI M.D. (MEMBER)
(856) 772-0700
Entity
Organization
Contact information
Practice address
1 BRITTON PL, SUITE 6, VOORHEES, NJ 08043-2514
(856) 772-0700
(856) 864-0310
Mailing address
1 BRITTON PL, SUITE 6, VOORHEES, NJ 08043-2514
(856) 772-0700
(856) 864-0310
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA05442400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0445029000
AMERIHEALTH
NJ
01
—
050886
VALUE OPTION
NJ
05
—
1491806
—
NJ
01
—
202304
MENTAL HEALTH NETWORK
NJ
01
—
7534730
AETNA
NJ
01
—
P3645687
OXFORD
NJ
Enumeration date
05/10/2007
Last updated
08/22/2020
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