Organization
RICHARD S. WITLIN MD PC
Active
Organization
RICHARD S. WITLIN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN ETTENHUBER (CREDENTIALING COORDINATOR)
(732) 560-9176
Entity
Organization
Contact information
Practice address
557 CRANBURY RD, SUITE 15, EAST BRUNSWICK, NJ 08816-5419
(732) 698-9300
Mailing address
557 CRANBURY RD, SUITE 15, EAST BRUNSWICK, NJ 08816-5419
(732) 698-9300
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA03593300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176675
MEDICARE NUMBER FOR PRACTICE
NJ
Enumeration date
02/15/2016
Last updated
02/15/2016
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