Healthcare Provider Details

I. General information

NPI: 1083293625
Provider Name (Legal Business Name): GELAREH HEDAYATI WINTERMYER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CAPITAL WAY STE 456
PENNINGTON NJ
08534-2521
US

IV. Provider business mailing address

2 CAPITAL WAY STE 456
PENNINGTON NJ
08534-2521
US

V. Phone/Fax

Practice location:
  • Phone: 609-303-4300
  • Fax:
Mailing address:
  • Phone: 609-303-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number25MA13242000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: