MEDICARE: HARISH B KOTHARI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician	32711	NJ
2	207KA0200X	Allergy Physician	131535	NY

General Provider Information

NPI Number	:	1003878943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARISH B KOTHARI MD

Provider Business Mailing Address
First Line	:	906 OAK TREE ROAD
Second Line	:	SUITE N
City	:	SOUTH PLAINFIELD
State	:	NJ
Zip	:	07080-5127
Country	:	US
Telephone Number	:	908-412-6588
Fax Number	:	908-412-6558

Provider Business Practice Location Address
First Line	:	906 OAK TREE ROAD
Second Line	:	SUITE N
City	:	SOUTH PLAINFIELD
State	:	NJ
Zip	:	07080-5127
Country	:	US
Telephone Number	:	908-412-6588
Fax Number	:	908-412-6558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	07/08/2007

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Directions to “ HARISH B KOTHARI MD” Practice Location

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