Provider Demographics
NPI:1013923143
Name:SEITZ, CORTNEY (PAC)
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:
Last Name:SEITZ
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 ROUTE 34
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9104
Mailing Address - Country:US
Mailing Address - Phone:732-974-0003
Mailing Address - Fax:732-970-4443
Practice Address - Street 1:1945 ROUTE 33
Practice Address - Street 2:K HOVNANIAN CHILDREN'S HOSPITAL
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753
Practice Address - Country:US
Practice Address - Phone:732-413-3626
Practice Address - Fax:732-776-2344
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00174300363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ135737UVPMedicare PIN