Provider Demographics
NPI:1427020296
Name:BUCHOLTZ, HARVEY KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:KENNETH
Last Name:BUCHOLTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2 LINCOLN HWY STE 501
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3961
Mailing Address - Country:US
Mailing Address - Phone:732-549-7470
Mailing Address - Fax:732-494-8956
Practice Address - Street 1:2333 MORRIS AVE
Practice Address - Street 2:B202
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:07083-5714
Practice Address - Country:US
Practice Address - Phone:908-688-2244
Practice Address - Fax:908-688-9190
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29928207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0502405Medicaid
NJ0502405Medicaid
NJAB6567878OtherDEA
NJC59088Medicare UPIN