Healthcare Provider Details

I. General information

NPI: 1649372079
Provider Name (Legal Business Name): ANNA NOWINOWSKA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 03/07/2023
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 STATE ROUTE 33 RTE 33
NEPTUNE NJ
07753-4859
US

IV. Provider business mailing address

170 OAK PL
FAIR HAVEN NJ
07704-3552
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-4203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25 MA070931
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA07093100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: