Healthcare Provider Details

I. General information

NPI: 1477248516
Provider Name (Legal Business Name): JEEVITHA ANTHONY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 MEMORIAL PKWY STE 300
PHILLIPSBURG NJ
08865-2748
US

IV. Provider business mailing address

4013 US HIGHWAY 9 STE 1
HOWELL NJ
07731-4021
US

V. Phone/Fax

Practice location:
  • Phone: 908-847-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA13076400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: