Individual
DR. ERIC W. BANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
MA48238
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010003124010
—
NJ
01
—
0350808000
AMERIHEALTH HMO PROVIDER
NJ
01
—
0811426
CIGNA PROVIDER #
NJ
01
—
147995
KEYSTONE INSURANCE ID
NJ
01
—
3373326
AETNA PROVIDER ID
NJ
05
—
5312302
—
NJ
01
—
60012703
HORIZON-MERCY
NJ
01
—
721570737
TAX ID#
NJ
05
—
83386
—
NJ
01
—
J017341
TRICARE PRIME PROVIDER ID
NJ
01
—
P381888
OXFORD PROVIDER ID
NJ
Enumeration date
01/23/2007
Last updated
07/05/2012
Update your record
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