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General NPI Number Information
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NPI Number | 1124017751
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Entity Type | Individual
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Provider Name | JEFFREY M PITTA PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 2700 WAYNE MEMORIAL DR EMERGENCY DEPT
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City | GOLDSBORO
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State | NC
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Zip | 27534-9494
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Country | US
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Telephone | 919-731-6060
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Fax | 919-580-9224
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Provider Business Mailing Address
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Address Line | PO BOX K
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City | GOLDSBORO
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State | NC
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Zip | 27533-9710
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Country | US
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Telephone | 919-580-0004
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Fax | 919-580-9224
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 102680
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License Number State | NC
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