Individual
DR. JONATHAN W. DITKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
108 BROUGHTON AVE, BLOOMFIELD, NJ 07003-3989
(973) 743-1331
(973) 743-6577
Mailing address
1 CORPORATE DR, WAYNE, NJ 07470-3112
(973) 987-3380
(866) 806-3675
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA06086100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6206000
—
NJ
Enumeration date
04/25/2006
Last updated
03/16/2022
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