Provider Demographics
NPI:1497194963
Name:HOLTZER, MATTHEW (PT)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:HOLTZER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-9306
Mailing Address - Country:US
Mailing Address - Phone:908-810-9002
Mailing Address - Fax:908-810-9012
Practice Address - Street 1:717 N BEERS ST STE 1E
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1525
Practice Address - Country:US
Practice Address - Phone:732-344-2192
Practice Address - Fax:732-344-2193
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01497200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist