Active NPI
Nicole L Witzig
- Physical Therapist
- Union, NJ
National Provider Identifier
1144577495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01452000
- Practice address
- 2360 Morris Ave
Union, NJ 07083-5707 - Phone
- (908) 206-1700
- Fax
- (908) 206-1720
- NPI assigned
- Aug 6, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01452000 | NJ | Primary |
Addresses
Primary practice location
2360 Morris Ave
Union, NJ 07083-5707
Mailing address
622 Eagle Rock Ave
West Orange, NJ 07052-2994
Phone (973) 669-0078
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01452000 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Twin Boro Physical Therapy Associates, PA | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Occupational Therapist
- Newark, NJ
- NPI 1659874857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390953600000",
"number": "1144577495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "622 EAGLE ROCK AVE",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070522994",
"telephone_number": "973-669-0078",
"fax_number": "973-669-1113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2360 MORRIS AVE",
"city": "UNION",
"state": "NJ",
"postal_code": "070835707",
"telephone_number": "908-206-1700",
"fax_number": "908-206-1720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITZIG",
"first_name": "NICOLE",
"middle_name": "L",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-06",
"last_updated": "2014-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01452000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Union, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.