Healthcare Provider Details

I. General information

NPI: 1144303421
Provider Name (Legal Business Name): ERIC LEE WINARSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 04/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 BROAD STREET SUITE102
SHREWSBURY NJ
07702
US

IV. Provider business mailing address

1131 BROAD STREET SUITE102
SHREWSBURY NJ
07702
US

V. Phone/Fax

Practice location:
  • Phone: 732-389-2500
  • Fax: 732-389-2820
Mailing address:
  • Phone: 732-389-2500
  • Fax: 732-389-2820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number25MA03369300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number25MA03369300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: