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General NPI Number Information
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NPI Number | 1750301115
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Entity Type | Individual
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Provider Name | WINSLOW PERCIVAL BRAITHWAITE PA
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 81 NORTHFIELD AVE STE 304
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City | WEST ORANGE
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State | NJ
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Zip | 07052-5344
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Country | US
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Telephone | 973-612-2214
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 ADAMS ST STE DE
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City | HOBOKEN
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State | NJ
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Zip | 07030-2370
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Country | US
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Telephone | 201-308-6622
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Fax | 201-308-6623
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 003950
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 25MP00046300
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License Number State | NJ
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