Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 224967 | MA |
N | 2080P0205X | Pediatric Endocrinologist | 224967 | MA |
Y | 2080P0205X | Pediatric Endocrinologist | 25MA08453800 | NJ |
NPI | 1023096450 |
---|---|
Provider Name | Dr. Jennifer Nicole Sivitz |
First Address | Livingston, NJ 07039-4532 |
Second Address | Livingston, NJ 07039-4532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 22/07/2019 |