Provider Demographics
NPI:1275857872
Name:LITWIN, ADAM MARK (DDS)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:MARK
Last Name:LITWIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SIXTH AVENUE
Mailing Address - Street 2:BUILDING SERVICE 32BJ HEALTH FUND
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013
Mailing Address - Country:US
Mailing Address - Phone:212-388-2099
Mailing Address - Fax:212-399-3156
Practice Address - Street 1:101 SIXTH AVENUE
Practice Address - Street 2:BUILDING SERVICE 32BJ HEALTH FUND
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013
Practice Address - Country:US
Practice Address - Phone:212-388-2099
Practice Address - Fax:212-399-3156
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0413611122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist