Individual
MATTHEW LETIZIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 WILLIAMSON ST, EMERGENCY DEPARTMENT, ELIZABETH, NJ 07202-3625
(908) 994-5454
(919) 425-0478
Mailing address
3114 CROASDAILE DR, SUITE 200, DURHAM, NC 27705-2508
(919) 425-1565
(919) 425-0478
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB08192400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0139882
—
NJ
Enumeration date
05/29/2007
Last updated
01/13/2015
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