Individual
BURTON JUDAH WISOTSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
485 ROUTE 1 S, BLDG A, ISELIN, NJ 08830-3009
(732) 750-0400
(732) 750-1507
Mailing address
485 ROUTE 1 S, BLDG A, ISELIN, NJ 08830-3009
(732) 750-0400
(732) 750-1507
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
1869411
NY
207W00000X
Ophthalmology Physician
Primary
25MA06274100
NJ
207WX0107X
Retina Specialist (Ophthalmology) Physician
186941-1
NY
207WX0107X
Retina Specialist (Ophthalmology) Physician
25MA06274100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01634931
—
NY
05
—
6675905
—
NJ
01
—
7871714QHY
MEDICARE
NY
01
—
BW073T7610
NY CARE
NY
Enumeration date
10/31/2005
Last updated
03/30/2017
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