# EWR MEDPORT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871890079
- **Authorized official:** DR. JEFFREY WITZ DC (DIRECTOR)
- **Authorized official phone:** (973) 877-0991

## Contact information

- **Practice address:** 339 BREWSTER RD, STE 201, NEWARK, NJ 07114
- **Practice address phone:** (973) 877-0991
- **Mailing address:** 339 BREWSTER RD, STE 201, NEWARK, NJ 07114
- **Mailing address phone:** (973) 877-0991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 25MA08091000 | NJ | — |
| 261QX0100X | Occupational Medicine Clinic/Center | 38MC00672500 | NJ | Yes |

## Other

- **Enumeration date:** 02/24/2011
- **Last updated:** 02/24/2011