Healthcare Provider Details

I. General information

NPI: 1275420622
Provider Name (Legal Business Name): MICHAEL ANTHONY WINIK DPM
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/19/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 W SHERMAN AVE # 93
VINELAND NJ
08360-7059
US

IV. Provider business mailing address

1505 W SHERMAN AVE # 93
VINELAND NJ
08360-7059
US

V. Phone/Fax

Practice location:
  • Phone: 646-596-2174
  • Fax:
Mailing address:
  • Phone: 646-596-2174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number213ES0103X
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: