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General NPI Number Information
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NPI Number | 1598243701
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Entity Type | Individual
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Provider Name | ROSHAN KOTTOOR
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Gender | Female
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 4344 W BELL RD
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City | GLENDALE
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State | AZ
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Zip | 85308-3589
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Country | US
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Telephone | 347-439-9011
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 E HIGHLAND AVE STE 100
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City | PHOENIX
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State | AZ
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Zip | 85016-4740
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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