Individual
DR. JACK H VITENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
277 FOREST AVE, SUITE 206, PARAMUS, NJ 07652-5410
(201) 489-8900
(201) 489-0877
Mailing address
277 FOREST AVE, SUITE 206, PARAMUS, NJ 07652-5410
(201) 489-8900
(201) 489-0877
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
25MA02553900
NJ
Other
Enumeration date
03/16/2006
Last updated
07/08/2007
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