Provider Demographics
NPI:1821252008
Name:NEETA MOTIWALA, M.D.P.C.
Entity Type:Organization
Organization Name:NEETA MOTIWALA, M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-678-0114
Mailing Address - Street 1:15 N 5TH ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-6100
Mailing Address - Country:US
Mailing Address - Phone:201-678-0114
Mailing Address - Fax:201-490-8822
Practice Address - Street 1:15 N 5TH ST
Practice Address - Street 2:SUITE 106
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-6100
Practice Address - Country:US
Practice Address - Phone:201-678-0114
Practice Address - Fax:201-490-8822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05097900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE 83859Medicare UPIN