Provider Demographics
NPI:1932499266
Name:KORNITZER, JEFFREY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:KORNITZER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:90 BERGEN ST
Mailing Address - Street 2:SUITE 8100
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2425
Mailing Address - Country:US
Mailing Address - Phone:973-972-7151
Mailing Address - Fax:973-972-9960
Practice Address - Street 1:90 BERGEN ST STE 8100
Practice Address - Street 2:ROOM F-603
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2425
Practice Address - Country:US
Practice Address - Phone:973-972-7151
Practice Address - Fax:973-972-1019
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2016-06-20
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA095716002084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology