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General NPI Number Information
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NPI Number | 1689172074
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Entity Type | Individual
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Provider Name | STEVEN FREDERICK SATZ STUDENT INTERN
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Gender | Male
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 777 BLOOMFIELD AVE
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City | CLIFTON
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State | NJ
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Zip | 07012-1242
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Country | US
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Telephone | 973-544-0125
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Fax |
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Provider Business Mailing Address
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Address Line | 4 LAKE END RD
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City | NEWFOUNDLAND
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State | NJ
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Zip | 07435-1206
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Country | US
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Telephone | 908-307-8112
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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