Individual
PHILIP LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 BAY AVE, MONTCLAIR, NJ 07042-4837
(800) 720-1664
Mailing address
PO BOX 35088, NEWARK, NJ 07193-5088
(800) 720-1664
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MA50393
NJ
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MA50393
NJ
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME142797
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4864808
—
NJ
Enumeration date
06/22/2005
Last updated
06/08/2021
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