Provider Demographics
NPI:1902851470
Name:KOT, JEFFREY B (AUD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:B
Last Name:KOT
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 CLIFTON AVE.
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011
Mailing Address - Country:US
Mailing Address - Phone:973-772-5457
Mailing Address - Fax:973-772-5457
Practice Address - Street 1:453 CLIFTON AVE.
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011
Practice Address - Country:US
Practice Address - Phone:973-772-5457
Practice Address - Fax:973-772-5457
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00040300231H00000X, 231HA2400X
NJ41YA00010300237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0040656OtherAETNA
NJ1445006Medicaid
010003040-00OtherAMERICHOICE
73000103NJ01OtherANTHEM HEALTH
5340463OtherAETNA
1048049OtherHORIZON NJ HEALTH
16237OtherUNIVERSITY HEALTH PLAN
PS168OtherOXFORD
001000510002OtherUNITED HEALTHCARE
15071OtherAMERIGROUP
16237OtherUNIVERSITY HEALTH PLAN