Provider Demographics
NPI:1316007792
Name:MALHOTRA, AMISHA (MD)
Entity Type:Individual
Prefix:DR
First Name:AMISHA
Middle Name:
Last Name:MALHOTRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4947
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:89 FRENCH ST STE 2300
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1935
Practice Address - Country:US
Practice Address - Phone:732-235-7894
Practice Address - Fax:732-235-7419
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA716402080P0208X
NJ25MA071640002080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8390304Medicaid
NJ8390304Medicaid
NJ044364C6DMedicare PIN