Provider Demographics
NPI:1851346985
Name:PEDOWITZ, ROBERT NEIL (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NEIL
Last Name:PEDOWITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:225 WILLOW BROOK RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5921
Mailing Address - Country:US
Mailing Address - Phone:732-462-9622
Mailing Address - Fax:732-780-0014
Practice Address - Street 1:161 BARTLEY RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1241
Practice Address - Country:US
Practice Address - Phone:732-363-6140
Practice Address - Fax:732-363-6196
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB71374207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9017305Medicaid
NJH76875Medicare UPIN
NJ9017305Medicaid