DR. BOLESLAV KOTLYAR (NPI# 1386986669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386986669 |
Entity Type | Individual |
Full Name | DR. BOLESLAV KOTLYAR |
Credential | MD |
Practice Address |
306 Main St Ste 2 Millburn NJ 07041-1178 |
Practice Telephone | 9734672020 |
Mailing Telephone | 9734672020 |
Enumeration Date | 2013-03-25 |
Last Update Date | 2019-08-16 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
036.143658 | IL | Allopathic & Osteopathic Physicians |
Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
25MA10677700 | NJ | Allopathic & Osteopathic Physicians |
N | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
286387 | NY | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
450 Clarkson Ave, Box 1262, Department Suny Downstate Medical Center, Brooklyn, NY 11203 | 7182708867 |
Street Address |
306 MAIN ST STE 2 |
City | MILLBURN |
State | NJ |
Zip Code | 07041-1178 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932696879 | Michael J. Kahn | Psychologist | 114 Millburn Avenue, Suite Number 200, Millburn, NJ 07041 | 2018-04-17 |
1780063586 | Beth Israel Medicial Center | General Acute Care Hospital | 927 Ridgewood Road, Millburn, NJ 07041 | 2015-05-26 |
1457762577 | Amy Ladetsky | Occupational Therapist | 25 Greenwood Drive, Millburn, NJ 07041 | 2014-05-12 |
1033384193 | Doris Marie Breckenridge | Psychiatry & Neurology | 116 Millburn Avenue, Suite 200, Millburn, NJ 07041 | 2008-04-29 |
1477722627 | M. Mai-tram D. Ho | Chiropractor | 58 Mountain Ave, Millburn, NJ 07041 | 2008-02-21 |
1689880320 | Wendy Caroline Wisz | Dentist | 250 Millburn Ave., Millburn, NJ 07041 | 2007-05-16 |
1578775680 | Margaret M Mcintyre | Dentist | 421 Essex St, Millburn, NJ 07041 | 2007-05-03 |
1225189210 | Regina Ann Schaefer | Social Worker | 55 Bleeker Street, Millburn, NJ 07041 | 2007-01-16 |
1124188800 | Patricia Ann Delgaldo | Social Worker | 368 Essex Street, 2nd Floor, Millburn, NJ 07041 | 2006-12-11 |
1366541690 | Mahesh R Desai | Internal Medicine | 120 Millburn Avenue, Suite M2, Millburn, NJ 07041 | 2006-09-22 |
Find all providers in zip 07041 |
Taxonomy Code | 207WX0107X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Ophthalmology |
Specialization | Retina Specialist |
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730574872 | Konstantin Astafurov | Ophthalmology | 10 Plum St Ste 600, New Brunswick, NJ 08901-2065 | 2015-04-06 |
1679625172 | Associated Retinal Surgeons, Pa | Ophthalmology | 8 Ranoldo Ter, Cherry Hill, NJ 08034-2112 | 2007-01-17 |
1013910942 | Haris Irfan Amin | Ophthalmology | 780 Route 37 W, Ste 200, Toms River, NJ 08755-5059 | 2005-05-24 |
1013280890 | Ravi Dilip Patel | Ophthalmology | 780 Rte 37 W, Suite 200, Toms River, NJ 08755-5059 | 2012-02-09 |
1831345578 | Retina Care Center, P.C. | Ophthalmology | 1255 Route 70 Ste 31n, Lakewood, NJ 08701-5973 | 2008-08-13 |
1316085566 | Mohammedyusuf Ebrahimadham Hajee | Ophthalmology | 780 Rte 37 W, Suite 200, Toms River, NJ 08755-5059 | 2007-02-01 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.