Individual
MIKHAIL KOTLOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 KALISA WAY, SUITE 210, PARAMUS, NJ 07652
(201) 447-0013
(201) 255-4515
Mailing address
1 KALISA WAY, SUITE 210, PARAMUS, NJ 07652
(201) 447-0013
(201) 255-4515
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
238660
NY
207RN0300X
Nephrology Physician
Primary
25MA08410200
NJ
Other
Enumeration date
01/23/2007
Last updated
10/04/2023
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