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General NPI Number Information
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NPI Number | 1770636920
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Entity Type | Organization
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Legal Business Name | MICHAEL C. PITTER, M D PA
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 201 LYONS AVE # L-2 AT OSBOURNE TERRACE
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City | NEWARK
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State | NJ
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Zip | 07112-2027
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Country | US
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Telephone | 973-926-4600
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Fax | 973-926-4601
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Provider Business Mailing Address
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Address Line | PO BOX 111573
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City | IRVINGTON
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State | NJ
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Zip | 07111-0573
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Country | US
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Telephone | 973-926-4600
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Fax | 973-926-4601
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MICHAEL C PITTER
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Credential | M.D.
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Telephone | 973-926-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA57077
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License Number State | NJ
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