Healthcare Provider Details

I. General information

NPI: 1720160427
Provider Name (Legal Business Name): ENRIQUE J PANTIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

12101 NW 27TH ST
PLANTATION FL
33323-1755
US

V. Phone/Fax

Practice location:
  • Phone: 732-937-8841
  • Fax: 732-418-8492
Mailing address:
  • Phone: 732-890-0640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA07011300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number25MA07011300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME95741
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: