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General NPI Number Information
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NPI Number | 1275865461
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Entity Type | Organization
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Legal Business Name | JEFFREY B DANZIG MD PC
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Dates
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Enumeration Date | 02/12/2010
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 127 UNION ST
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-4478
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Country | US
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Telephone | 201-445-8787
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Fax | 201-445-8556
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Provider Business Mailing Address
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Address Line | 2 WINTHROP DR
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City | WOODCLIFF LAKE
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State | NJ
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Zip | 07677-7856
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Country | US
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Telephone | 201-445-8787
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Fax | 201-445-8556
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY B DANZIG
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Credential | MD
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Telephone | 201-445-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MA54828
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License Number State | NJ
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