Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 25MB06116900 | NJ |
NPI | 1003887704 |
---|---|
Provider Name | Robert Koch Ilowite |
First Address | Hillsborough, NJ 08844-4528 |
Second Address | Hillsborough, NJ 08844-4528 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 10/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070014217 | RAILROAD MEDICARE (01) | NJ |
0809116000 | AMERIHEALTH GROUP NUMBER (01) | NJ |
1003887704 | NPI (01) | NJ |
1427926 | UNITED HEALTHCARE (01) | NJ |
223539248 | TAX ID (01) | NJ |
2K9800 | HEALTHNET (01) | NJ |
4843856004 | CIGNA HEALTHCARE PAL (01) | NJ |
578537 | AETNA HEALTH, INC. (01) | NJ |
F96512 | (02) | NJ |
P1003739 | OXFORD (01) | NJ |