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General NPI Number Information
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NPI Number | 1992900013
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Entity Type | Organization
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Legal Business Name | MARK C. NITZBERG, P.C.
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 380 R MERRIMACK ST. STE. 2C
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City | METHUEN
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State | MA
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Zip | 01844
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Country | US
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Telephone | 978-681-1977
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Fax | 978-686-8918
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Provider Business Mailing Address
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Address Line | 380 R MERRIMACK ST. STE. 2C
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City | METHUEN
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State | MA
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Zip | 01844
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Country | US
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Telephone | 978-681-1977
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Fax | 978-686-8918
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK C. NITZBERG
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Credential | M.D.
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Telephone | 978-681-1977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 74584
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 74584
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License Number State | MA
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