Organization
WIJE KOTTAHACHCHI, MD FAAP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WIJE KOTTAHACHCHI MD (CEO)
(732) 442-1820
Entity
Organization
Contact information
Practice address
468 AMBOY AVE, PERTH AMBOY, NJ 08861-3143
(732) 442-1820
(732) 442-2918
Mailing address
468 AMBOY AVE, PERTH AMBOY, NJ 08861-3143
(732) 442-1820
(732) 442-2918
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2442809
—
NJ
Enumeration date
09/24/2014
Last updated
09/24/2014
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