Larisa Klots DO Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MB71358 Issued in NJ

Legal business name

LARISA KLOTS DO INC

Practice address

B3 Brier Hill CT
E Brunswick, NJ 08816-3330

Phone

(732) 254-1114

Fax

(732) 254-2247

NPI assigned

Sep 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Larisa Klots, DONPI 1053361550

Title

President

Phone

(732) 257-8442

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Larisa Klots, DO

  • Family Medicine Physician
  • East Brunswick, NJ
  • NPI 1053361550
  Medicare reassignment NPD Authorized official
• Arkadiy Shraytman, D.O.

  • Family Medicine Physician
  • Wayne, NJ
  • NPI 1932103355
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378425600000",
    "number": "1649379181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BUFFALO RUN",
            "city": "E BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164078",
            "telephone_number": "732-254-1114",
            "fax_number": "732-254-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B3 BRIER HILL CT",
            "city": "E BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163330",
            "telephone_number": "732-254-1114",
            "fax_number": "732-254-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARISA KLOTS DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2013-09-06",
        "status": "A",
        "authorized_official_last_name": "KLOTS",
        "authorized_official_first_name": "LARISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-257-8442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB71358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in E Brunswick, NJ
• Providers in E Brunswick, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.