Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 38MC00672500 | NJ |
NPI | 1023331337 |
---|---|
Provider Name | Dr. Jeffrey Witz |
First Address | Newark, NJ 07114 |
Second Address | Newark, NJ 07114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2010 |
Last Update Date | 02/03/2010 |