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Individual

ADAM SIVITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-2484
(973) 282-0562
Mailing address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-2484
(973) 282-0562

Taxonomy

Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
25MA08446300
NJ
208000000X
Pediatrics Physician
MD11817
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1508872631
NPI
05
7058391
RI
01
939025129
RI MEDICARE GROUP NUMBER
Enumeration date
07/31/2006
Last updated
09/11/2009
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