Organization
NEW GW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ANNE ETTENHUBER (PRACTICE MANAGER)
(732) 698-9300
Entity
Organization
Contact information
Practice address
385 ROUTE 18 STE H, EAST BRUNSWICK, NJ 08816-5703
(732) 698-9300
(732) 254-0786
Mailing address
385 ROUTE 18 STE H, EAST BRUNSWICK, NJ 08816-5703
(732) 698-9300
(732) 254-0786
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
01/05/2018
Last updated
01/05/2018
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