Healthcare Provider Details
I. General information
NPI: 1659373421
Provider Name (Legal Business Name): ERWIN J OEI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/11/2005
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 SPRINGFIELD AVE 3RD FLOOR
SUMMIT NJ
07901-4055
US
IV. Provider business mailing address
PO BOX 416457
BOSTON MA
02241-6457
US
V. Phone/Fax
- Phone: 908-934-0555
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 25MA07010700 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: