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General NPI Number Information
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NPI Number | 1528791043
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Entity Type | Individual
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Provider Name | THOMAS WITEK DC
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Gender | Male
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 454 ELIZABETH AVE
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City | SOMERSET
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State | NJ
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Zip | 08873-5111
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Country | US
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Telephone | 732-860-5757
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Fax |
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Provider Business Mailing Address
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Address Line | 410 CLINTON ST
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City | LINDEN
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State | NJ
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Zip | 07036-3214
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Country | US
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Telephone | 908-943-4514
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00793600
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License Number State | NJ
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