Healthcare Provider Details

I. General information

NPI: 1538109699
Provider Name (Legal Business Name): BARRY WITT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/08/2020
Certification Date: 07/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 HOLLY HILL LN STE 270
GREENWICH CT
06830-6074
US

IV. Provider business mailing address

55 HOLLY HILL LN STE 270
GREENWICH CT
06830-6074
US

V. Phone/Fax

Practice location:
  • Phone: 32-863-2990
  • Fax:
Mailing address:
  • Phone: 32-863-2990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number168909
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: