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NPI Code Detail

MEDICARE: PHILIP KREVITT DMD PA

MEDICARE: PHILIP KREVITT DMD PA
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
11223P0700XProsthodontics

General Provider Information

NPI Number : 1336297092
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHILIP KREVITT DMD PA
Provider Business Mailing Address
First Line : 1625 ANDERSON AVE
Second Line :
City : FORT LEE
State : NJ
Zip : 07024-2748
Country : US
Telephone Number : 201-944-1260
Fax Number : 201-944-1261
Provider Business Practice Location Address
First Line : 1625 ANDERSON AVE
Second Line :
City : FORT LEE
State : NJ
Zip : 07024-2748
Country : US
Telephone Number : 201-944-1260
Fax Number : 201-944-1261
Authorized Official
Title or Position : OWNER
Name : DR. PHILIP KREVITT
Credential : DMD
Telephone Number : 201-944-1260
Provider Enumeration Date : 01/08/2007
Last Update Date : 08/22/2020

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Directions to “PHILIP KREVITT DMD PA ” Practice Location

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