Provider Demographics
NPI:1003887704
Name:ILOWITE, ROBERT KOCH (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:KOCH
Last Name:ILOWITE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:505 OMNI DR
Mailing Address - Street 2:THE DERMATOLOGY CENTER
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4528
Mailing Address - Country:US
Mailing Address - Phone:908-359-6685
Mailing Address - Fax:908-359-0649
Practice Address - Street 1:505 OMNI DR
Practice Address - Street 2:THE DERMATOLOGY CENTER
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4528
Practice Address - Country:US
Practice Address - Phone:908-359-6685
Practice Address - Fax:908-359-0649
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB06116900207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1003887704OtherNPI
NJ223539248OtherTAX ID
NJ0809116000OtherAMERIHEALTH GROUP NUMBER
NJ4843856004OtherCIGNA HEALTHCARE PAL
NJ578537OtherAETNA HEALTH, INC.
NJ070014217OtherRAILROAD MEDICARE
NJ2K9800OtherHEALTHNET
NJP1003739OtherOXFORD
NJ1427926OtherUNITED HEALTHCARE
NJ223539248OtherTAX ID
NJ2K9800OtherHEALTHNET