Provider Demographics
NPI:1013223387
Name:ROBERT WOOD JOHNSON KIDNEY PANCREAS TRANSPLANT ASSOCIATES
Entity Type:Organization
Organization Name:ROBERT WOOD JOHNSON KIDNEY PANCREAS TRANSPLANT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:WINNAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-418-8033
Mailing Address - Street 1:1 ROBERT WOOD JOHNSON PL
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1928
Mailing Address - Country:US
Mailing Address - Phone:732-937-8537
Mailing Address - Fax:
Practice Address - Street 1:120 ALBANY ST FL 27
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2163
Practice Address - Country:US
Practice Address - Phone:732-937-8537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant SurgeryGroup - Multi-Specialty