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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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