Healthcare Provider Details

I. General information

NPI: 1801853049
Provider Name (Legal Business Name): DONALD NELSON COTLER M.D.,F.A.A.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 MILLBURN AVE
MILLBURN NJ
07041-1825
US

IV. Provider business mailing address

171 MILLBURN AVE
MILLBURN NJ
07041-1825
US

V. Phone/Fax

Practice location:
  • Phone: 973-912-0400
  • Fax: 973-912-8340
Mailing address:
  • Phone: 973-912-0400
  • Fax: 973-912-8340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMA047885
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: