Provider Demographics
NPI:1659486611
Name:ORWITZ, JONATHAN I (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:I
Last Name:ORWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:693 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-5043
Mailing Address - Country:US
Mailing Address - Phone:609-261-7600
Mailing Address - Fax:
Practice Address - Street 1:693 MAIN ST
Practice Address - Street 2:BLDG B & D
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-5043
Practice Address - Country:US
Practice Address - Phone:609-261-7600
Practice Address - Fax:609-265-8205
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2505532084N0400X
GA0619922084N0400X
FLME1036792084N0400X
MT1542084N0400X
MA2278142084N0400X
NC263372084N0400X
VA01012446902084N0400X
NJ25MA045956002084N0400X
NJMD4412062084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2346206Medicaid
NJ2346206Medicaid
077356Medicare Oscar/Certification
197724SK3Medicare PIN