Healthcare Provider Details

I. General information

NPI: 1669467890
Provider Name (Legal Business Name): MARTIN E CORWIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 09/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 EAGLE ROCK AVE
EAST HANOVER NJ
07936-3104
US

IV. Provider business mailing address

46 EAGLE ROCK AVE
EAST HANOVER NJ
07936-3104
US

V. Phone/Fax

Practice location:
  • Phone: 973-560-1500
  • Fax: 973-560-0419
Mailing address:
  • Phone: 973-560-1500
  • Fax: 973-560-0419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMA01954500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: