Healthcare Provider Details

I. General information

NPI: 1649621269
Provider Name (Legal Business Name): JENS J WITSCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2016
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 HARRISBURG PIKE SUITE 200A
LANCASTER PA
17601-2644
US

IV. Provider business mailing address

2150 HARRISBURG PIKE SUITE 200A
LANCASTER PA
17601-2644
US

V. Phone/Fax

Practice location:
  • Phone: 717-396-9167
  • Fax: 717-396-9064
Mailing address:
  • Phone: 717-396-9167
  • Fax: 717-396-9064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberMD475332
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD475332
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: