Ewr Medport

Primary specialty

Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X

License

38MC00672500 Issued in NJ

Legal business name

EWR MEDPORT

Practice address

339 Brewster Rd
Ste 201
Newark, NJ 07114

Phone

(973) 877-0991

NPI assigned

Feb 24, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeffrey Witz, DC

Title

Director

Phone

(973) 877-0991

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298505600000",
    "number": "1871890079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 BREWSTER RD",
            "address_2": "STE 201",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07114",
            "telephone_number": "973-877-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 BREWSTER RD",
            "address_2": "STE 201",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07114",
            "telephone_number": "973-877-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EWR MEDPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-24",
        "last_updated": "2011-02-24",
        "status": "A",
        "authorized_official_last_name": "WITZ",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "973-877-0991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NJ",
            "license": "25MA08091000",
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "NJ",
            "license": "38MC00672500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Medicine Clinic/Center in Newark, NJ
• Providers in Newark, NJ by specialty
• Occupational Medicine Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.