Provider Demographics
NPI:1376738732
Name:POMERANTZ, JEFFREY DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DAVID
Last Name:POMERANTZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 PARKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1823
Mailing Address - Country:US
Mailing Address - Phone:856-785-9296
Mailing Address - Fax:
Practice Address - Street 1:4295 RT 47
Practice Address - Street 2:
Practice Address - City:DELMONT
Practice Address - State:NJ
Practice Address - Zip Code:08314
Practice Address - Country:US
Practice Address - Phone:856-785-8106
Practice Address - Fax:856-785-9307
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07535500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine