Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 25MA03369300 | NJ |
NPI | 1144303421 |
---|---|
Provider Name | Eric Lee Winarsky |
First Address | Shrewsbury, NJ 07702 |
Second Address | Shrewsbury, NJ 07702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 30/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C54459 | (02) |