Provider Demographics
NPI:1922189513
Name:CT HOLDINGS MEDICAL GROUP LLC
Entity type:Organization
Organization Name:CT HOLDINGS MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:TROTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-625-2407
Mailing Address - Street 1:1 EVES DR STE 111
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3125
Mailing Address - Country:US
Mailing Address - Phone:856-357-3247
Mailing Address - Fax:856-249-9164
Practice Address - Street 1:1 EVES DR STE 111
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3125
Practice Address - Country:US
Practice Address - Phone:856-357-3247
Practice Address - Fax:856-249-9164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07948800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ097676Medicare ID - Type Unspecified
NJDE5983Medicare PIN