=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740224427
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALKA P LOTHE MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 154 HWY 37 W
-----------------------------------------------------
City | TOMS RIVER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08755
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-244-0777
-----------------------------------------------------
Fax | 732-244-1428
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 154 HWY 37 W
-----------------------------------------------------
City | TOMS RIVER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08755
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-244-0777
-----------------------------------------------------
Fax | 732-244-1428
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0202X
-----------------------------------------------------
Taxonomy Name | Diagnostic Radiology Physician
-----------------------------------------------------
License Number | 25MA03493500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------