Healthcare Provider Details

I. General information

NPI: 1538891023
Provider Name (Legal Business Name): NISHEL YOGESH KOTHARI M.B.B.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2022
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date: 03/20/2023
Reactivation Date: 06/22/2023

III. Provider practice location address

1 MEDICAL CENTER DR DHMC DEPARTMENT OF NEUROLOGY
LEBANON NH
03756
US

IV. Provider business mailing address

1 MEDICAL CENTER DR DHMC DEPARTMENT OF NEUROLOGY
LEBANON NH
03756
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-5000
  • Fax:
Mailing address:
  • Phone: 731-472-0310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: