Individual
ANDREW BLITZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 PROSPECT AVE STE 613, HACKENSACK, NJ 07601-1962
(212) 262-4444
(212) 523-8165
Mailing address
20 PROSPECT AVE STE 613, HACKENSACK, NJ 07601-1962
(212) 262-9500
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
120296
NY
207Y00000X
Otolaryngology Physician
120296
NY
207Y00000X
Otolaryngology Physician
W23126514C
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00250197
—
NY
Enumeration date
09/15/2006
Last updated
01/31/2024
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