| Dr Gautam H Kothari, DO | |
|
243 Us Highway 130 Ste 100, Bordentown, NJ 08505-2137 | |
| (609) 267-9400 | |
| (609) 424-3517 |
| Full Name | Dr Gautam H Kothari |
|---|---|
| Gender | Male |
| Speciality | Physical Medicine And Rehabilitation |
| Experience | 22 Years |
| Location | 243 Us Highway 130 Ste 100, Bordentown, New Jersey |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821251968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 25MB08908900 (New Jersey) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Virtua West Jersey Hospitals | Voorhees, NJ | Hospital |
| Virtua Willingboro Hospital | Willingboro, NJ | Hospital |
| Virtua Memorial Hospital Of Burlington County | Mount holly, NJ | Hospital |
| Virtua Our Lady Of Lourdes Hospital | Camden, NJ | Hospital |
| Robert Wood Johnson University Hospital At Hamilton | Hamilton, NJ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Virtua Medical Group, Pa | 9830222397 | 1674 |
| Entity Name | Mercer Bucks Orthopaedics P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801843511 PECOS PAC ID: 0042116345 Enrollment ID: O20031216000024 |
| Entity Name | Premier Brain And Spine Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922771377 PECOS PAC ID: 6608264833 Enrollment ID: O20211021000001 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gautam H Kothari, DO 301 Lippincott Dr Ste 410, Marlton, NJ 08053-4197 Ph: (609) 267-9400 | Dr Gautam H Kothari, DO 243 Us Highway 130 Ste 100, Bordentown, NJ 08505-2137 Ph: (609) 267-9400 |
Michael H. Rizkalla, MD Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 9500 K Johnson Blvd, Ste 1, Bordentown, NJ 08505 Phone: 609-817-0050 Fax: 609-588-8602 |