Organization Active NPI

Neville H. Kotwal, MD, LLC

  • Psychiatry Physician
  • Bethlehem, PA
National Provider Identifier
1659629780
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD044889L Issued in PA
Legal business name
NEVILLE H. KOTWAL, MD, LLC
Practice address
601 E Broad St
Bethlehem, PA 18018-6332
Phone
(610) 882-1355
Fax
(610) 882-3181
NPI assigned
Aug 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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

Authorized official

Name
Neville H. Kotwal, M.D.
Title
Owner
Phone
(610) 882-1355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X MD044889L PA Primary

Addresses

Primary practice location

601 E Broad St
Bethlehem, PA 18018-6332

Mailing address

601 E Broad St
Bethlehem, PA 18018-6332
Phone (610) 882-1355

Other identifiers 1

IdentifierTypeStateIssuer
001271910-0011MedicaidPA

National Provider Directory

National Provider Directory

Locations

601 E Broad St
Bethlehem, PA 18018
Phone (610) 882-1355

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345507200000",
    "number": "1659629780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E BROAD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186332",
            "telephone_number": "610-882-1355",
            "fax_number": "610-882-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E BROAD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180186332",
            "telephone_number": "610-882-1355",
            "fax_number": "610-882-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVILLE H. KOTWAL, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-21",
        "last_updated": "2012-08-21",
        "status": "A",
        "authorized_official_last_name": "KOTWAL",
        "authorized_official_first_name": "NEVILLE",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-882-1355",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD044889L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001271910-0011",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.