Provider Demographics
NPI:1477537181
Name:LITVIN CENTERS FOR DIABETES
Entity Type:Organization
Organization Name:LITVIN CENTERS FOR DIABETES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:LITVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-461-0585
Mailing Address - Street 1:158 LINWOOD PLZ
Mailing Address - Street 2:STE 318-323
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3704
Mailing Address - Country:US
Mailing Address - Phone:201-461-0585
Mailing Address - Fax:201-461-1546
Practice Address - Street 1:158 LINWOOD PLZ
Practice Address - Street 2:STE 318-323
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-3704
Practice Address - Country:US
Practice Address - Phone:201-461-0585
Practice Address - Fax:201-461-1546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA58710207RE0101X
NY161098207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4270388OtherAETNA
NJ3644880OtherCIGNA
NJ0254814000OtherAMERIHEALTH
NJOK0726OtherHEALTH NET
NJNS2464OtherOXFORD
NJ5169670001OtherDURABLE MEDICAL EQUIPMENT
NJNS2464OtherOXFORD
092709Medicare ID - Type Unspecified