Individual
MARC H. LAVIETES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
90 BERGEN ST, DOC 4500, NEWARK, NJ 07103-2425
(973) 972-2500
(973) 972-2510
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
25MA03052600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0205702
—
NJ
Enumeration date
10/03/2006
Last updated
01/24/2022
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