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NPI Code Detail

MEDICARE: JEFFREY M PITTA PA-C

MEDICARE: JEFFREY M PITTA PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant102680NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAL LICENSEOTHERNC102551

General Provider Information

NPI Number : 1124017751
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY M PITTA PA-C
Provider Business Mailing Address
First Line : PO BOX K
Second Line :
City : GOLDSBORO
State : NC
Zip : 27533-9710
Country : US
Telephone Number : 919-580-0004
Fax Number : 919-580-9224
Provider Business Practice Location Address
First Line : 2700 WAYNE MEMORIAL DR
Second Line : EMERGENCY DEPT
City : GOLDSBORO
State : NC
Zip : 27534-9494
Country : US
Telephone Number : 919-731-6060
Fax Number : 919-580-9224
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 03/25/2021

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Directions to “ JEFFREY M PITTA PA-C” Practice Location

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