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NPI Code Detail

MEDICARE: PHILIP LUTZ M.D.

MEDICARE: PHILIP LUTZ M.D.
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
1207L00000XAnesthesiology PhysicianMA50393NJ
2207LP2900XPain Medicine (Anesthesiology) PhysicianME142797FL
3207LP2900XPain Medicine (Anesthesiology) PhysicianMA50393NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275539645
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIP LUTZ M.D.
Provider Business Mailing Address
First Line : PO BOX 35088
Second Line :
City : NEWARK
State : NJ
Zip : 07193-5088
Country : US
Telephone Number : 800-720-1664
Fax Number :
Provider Business Practice Location Address
First Line : 1 BAY AVE
Second Line :
City : MONTCLAIR
State : NJ
Zip : 07042-4837
Country : US
Telephone Number : 800-720-1664
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 06/08/2021

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Directions to “ PHILIP LUTZ M.D.” Practice Location

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