Doctor Name: | MR. MATTHEW HOLTZER |
NPI Number: | 1497194963 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 40QA01497200 |
Business Practice Address: | 418 Chestnut St Union, NJ - 070839306 |
Business Phone Number: | 9088109002 |
Business Fax Number: | 9088109012 |
Mailing Address: | 418 Chestnut St, UNION |
State: | NJ |
Postal Code: | 070839306 |
Phone Number: | 9088109002 |
Fax Number: | 9088109012 |
NPI Enumeration Date: | 06/18/2013 |
NPI Last Update Date: | 06/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 40QA01497200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |