Healthcare Provider Details

I. General information

NPI: 1083684567
Provider Name (Legal Business Name): EILEEN RUTH CONTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3322 RTE 22 W BLDG 5 STE 511
BRANCHBURG NJ
08876
US

IV. Provider business mailing address

3322 RTE 22 W BLDG 5 STE 511
BRANCHBURG NJ
08876
US

V. Phone/Fax

Practice location:
  • Phone: 908-595-1322
  • Fax: 908-595-1325
Mailing address:
  • Phone: 908-595-1322
  • Fax: 908-595-1325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMA67689
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: