Provider Demographics
NPI:1639124431
Name:LOTUS CLINICS PC
Entity Type:Organization
Organization Name:LOTUS CLINICS PC
Other - Org Name:LOTUS MEDICAL CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VEDAT
Authorized Official - Middle Name:
Authorized Official - Last Name:OBUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-937-2297
Mailing Address - Street 1:515 S BROAD ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611-1819
Mailing Address - Country:US
Mailing Address - Phone:609-392-6950
Mailing Address - Fax:609-392-6739
Practice Address - Street 1:515 S BROAD ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-1819
Practice Address - Country:US
Practice Address - Phone:609-392-6950
Practice Address - Fax:609-392-6739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0053414Medicaid
NJ0053414Medicaid