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Individual

DR. PRINCE G KOTTIATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
ROUTE 72, NEW LISBON DEVELOPMENTAL CENTER, HEALTH SERVICES, NEW LISBON, NJ 08064
(609) 726-1000
Mailing address
714 FORD AVE, LANGHORNE, PA 19047
(267) 566-4543

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25 MA07635200
NJ
207R00000X
Internal Medicine Physician
MD421855
PA

Other

Enumeration date
10/03/2006
Last updated
07/08/2007
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