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General NPI Number Information
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NPI Number | 1609981463
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Entity Type | Individual
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Provider Name | IAN SAUL WITTENBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 11/30/2025
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Provider Practice Location Address
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Address Line | 1650 GRAND CONCOURSE ACN-3 PEDS, 4TH FLOOR INPATIENT, 5TH FLOOR NURSERY
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City | BRONX
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State | NY
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Zip | 10457-7606
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Country | US
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Telephone | 718-590-1800
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Fax | 718-518-5692
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Provider Business Mailing Address
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Address Line | 1650 GRAND CONCOURSE DEPT OF PEDIATRICS SELWYN AVE BLDG SUITE 6D
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City | BRONX
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State | NY
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Zip | 10457-7606
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Country | US
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Telephone | 718-960-1415
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Fax | 718-518-5124
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 203517
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License Number State | NY
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