Individual
DR. JOHN JAY KRAVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15000 MIDLANTIC DR, SUITE 110, MOUNT LAUREL, NJ 08054-1573
(856) 996-4001
(856) 996-4007
Mailing address
15000 MIDLANTIC DR, SUITE 110, MOUNT LAUREL, NJ 08054-1573
(856) 996-4001
(856) 996-4007
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
25MA03264500
NJ
207RG0100X
Gastroenterology Physician
MD014473E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659328698
GROUP NPI #
NJ
01
—
1659328698
GROUP NPI #
PA
Enumeration date
05/05/2006
Last updated
09/21/2012
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