| Cotler Family Practice, Llc | |
|
1937 Highway 35 Suite 2 Wall Township NJ 07719-3559 | |
| (732) 449-0914 | |
| (732) 449-5437 |
| Full Name | Cotler Family Practice, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1937 Highway 35, Wall Township, New Jersey |
| Authorized Official Name and Position | Harold Cotler (PRESIDENT) |
| Authorized Official Contact | 7324490914 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cotler Family Practice, Llc 1937 Highway 35 Suite 2 Wall Township NJ 07719-3559 Ph: (732) 449-0914 | Cotler Family Practice, Llc 1937 Highway 35 Suite 2 Wall Township NJ 07719-3559 Ph: (732) 449-0914 |
| NPI Number | 1073763637 |
|---|---|
| Provider Enumeration Date | 09/19/2008 |
| Last Update Date | 09/19/2008 |
| Medicare PECOS PAC ID | 5395073621 |
|---|---|
| Medicare Enrollment ID | O20190826000747 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073763637 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MB38353 (New Jersey) | Primary |
| Provider Name | Harold Mark Cotler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659355832 PECOS PAC ID: 9638349145 Enrollment ID: I20110818000724 |
| Provider Name | Samantha L Cotler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598142523 PECOS PAC ID: 7517227184 Enrollment ID: I20190826002141 |
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