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NPI Code Detail

MEDICARE: DR. PHILIP HAROLD WITT PH.D.

MEDICARE: DR. PHILIP HAROLD WITT PH.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
1103T00000XPsychologist1305NJ

General Provider Information

NPI Number : 1619018843
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHILIP HAROLD WITT PH.D.
Provider Business Mailing Address
First Line : 25 N DOUGHTY AVE
Second Line :
City : SOMERVILLE
State : NJ
Zip : 08876-1811
Country : US
Telephone Number : 908-526-1177
Fax Number :
Provider Business Practice Location Address
First Line : 25 N DOUGHTY AVE
Second Line :
City : SOMERVILLE
State : NJ
Zip : 08876-1811
Country : US
Telephone Number : 908-526-1177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2007
Last Update Date : 07/08/2007

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