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1205415866
SHIVA KOTHARI
JACKSON, MS
NPI
1205415866
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-04-02
Last Update Date
2021-04-02
Business Address
SHIVA KOTHARI MD
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 516-509-1765
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Mailing Address
SHIVA KOTHARI MD
106 KAY ST
JERICHO, NY 11753-2659
Phone number: 516-509-1765
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