Healthcare Provider Details

I. General information

NPI: 1013223387
Provider Name (Legal Business Name): ROBERT WOOD JOHNSON KIDNEY PANCREAS TRANSPLANT ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 08/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 ALBANY ST FL 27
NEW BRUNSWICK NJ
08901-2163
US

IV. Provider business mailing address

1 ROBERT WOOD JOHNSON PL
NEW BRUNSWICK NJ
08901-1928
US

V. Phone/Fax

Practice location:
  • Phone: 732-937-8537
  • Fax:
Mailing address:
  • Phone: 732-937-8537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW WINNAKER
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 732-418-8033