Healthcare Provider Details

I. General information

NPI: 1447259023
Provider Name (Legal Business Name): ALAN KIVITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 MEADOWBROOK LN
DUNCANSVILLE PA
16635-8445
US

IV. Provider business mailing address

175 MEADOWBROOK LN
DUNCANSVILLE PA
16635-8445
US

V. Phone/Fax

Practice location:
  • Phone: 814-693-0300
  • Fax: 814-693-0400
Mailing address:
  • Phone: 814-693-0300
  • Fax: 814-693-0400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD026744E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: