Healthcare Provider Details

I. General information

NPI: 1649375759
Provider Name (Legal Business Name): SETH J KANOWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 05/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 MADISON AVE SUITE 105
MORRISTOWN NJ
07960-6092
US

IV. Provider business mailing address

PO BOX 3001
VOORHEES NJ
08043-0598
US

V. Phone/Fax

Practice location:
  • Phone: 973-644-0808
  • Fax: 973-644-9270
Mailing address:
  • Phone: 856-782-3300
  • Fax: 856-504-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35087532
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number25MA08211600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: