Provider Demographics
NPI:1336103050
Name:ALLOTEH, ROSE S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:S
Last Name:ALLOTEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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 1:1 ROBERT WOOD JOHNSON PL
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1928
Practice Address - Country:US
Practice Address - Phone:732-828-3000
Practice Address - Fax:732-235-6131
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07351200207L00000X
NJ25MA07351200207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00628628OtherRR MCR PTAN
NJ8882606Medicaid
NJP00953269OtherRR MCR PTAN
NJ063421CDZMedicare PIN
NJ063421AGNMedicare ID - Type Unspecified
NJP00628628OtherRR MCR PTAN
NJ063421CDYMedicare PIN
NJ8882606Medicaid