Provider Demographics
NPI:1770973745
Name:KOHLI, NILA R
Entity type:Individual
Prefix:MRS
First Name:NILA
Middle Name:R
Last Name:KOHLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PAVILION RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4183
Mailing Address - Country:US
Mailing Address - Phone:856-751-8688
Mailing Address - Fax:
Practice Address - Street 1:870 ROUTE EAST 70
Practice Address - Street 2:CARE ONE AT EVESHAM
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-396-0005
Practice Address - Fax:856-396-0004
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00382700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist