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Individual

MS. RENATA ANN WITKOWSKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
200 LAKE ST, NEWBURGH, NY 12550-5243
(845) 563-9990
(845) 563-9992
Mailing address
200 LAKE ST, NEWBURGH, NY 12550-5243
(845) 563-9990
(845) 563-9992

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
002081
NY
207R00000X
Internal Medicine Physician
002081
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00472931
NY
01
331832
MEDICARE
Enumeration date
08/31/2005
Last updated
01/30/2013
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