Provider Demographics
NPI:1336165273
Name:PREVITI, FRANCIS W (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:W
Last Name:PREVITI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 TILTON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1858
Mailing Address - Country:US
Mailing Address - Phone:609-568-5606
Mailing Address - Fax:609-303-2482
Practice Address - Street 1:1601 TILTON RD
Practice Address - Street 2:SUITE 4
Practice Address - City:NORTH FIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225
Practice Address - Country:US
Practice Address - Phone:609-568-5606
Practice Address - Fax:609-303-2482
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA33857208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1996100Medicaid
D06089Medicare UPIN
PR37113Medicare ID - Type Unspecified