Provider Demographics
NPI:1992043178
Name:COVITZ, MARC E (APN)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:E
Last Name:COVITZ
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 BURLINGTON PATH RD
Mailing Address - Street 2:
Mailing Address - City:CREAM RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08514-1604
Mailing Address - Country:US
Mailing Address - Phone:609-738-3016
Mailing Address - Fax:609-738-3016
Practice Address - Street 1:117 BURLINGTON PATH RD
Practice Address - Street 2:
Practice Address - City:CREAM RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08514-1604
Practice Address - Country:US
Practice Address - Phone:609-738-3016
Practice Address - Fax:609-738-3016
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN10244200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily