Individual
DR. RAJESH S KOTHARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
495 N 13TH ST, NEWARK, NJ 07107-1317
(973) 268-1400
Mailing address
66 W GILBERT ST, SUITE 100, TINTON FALLS, NJ 07701-4918
(732) 212-0060
(732) 212-0061
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB06966000
NJ
208D00000X
General Practice Physician
25MB06966000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24956
UHP NON PAR #
NJ
05
—
8806306
—
NJ
Enumeration date
08/19/2005
Last updated
06/17/2009
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