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Individual

MR. JUSTIN KOTLIAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 CAPITAL WAY, PENNINGTON, NJ 08534-2520
(800) 637-2374
Mailing address
1 FEDERAL ST STE 200, CAMDEN, NJ 08103-1088
(848) 288-6935

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
25MA12259500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
13-3971298
NY
Enumeration date
04/22/2018
Last updated
11/12/2025
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