Provider Demographics
NPI:1083684567
Name:CONTI, EILEEN RUTH (MD)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:RUTH
Last Name:CONTI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3322 RTE 22 W
Mailing Address - Street 2:BLDG 5 STE 511
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876
Mailing Address - Country:US
Mailing Address - Phone:908-595-1322
Mailing Address - Fax:908-595-1325
Practice Address - Street 1:3322 RTE 22 W
Practice Address - Street 2:BLDG 5 STE 511
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876
Practice Address - Country:US
Practice Address - Phone:908-595-1322
Practice Address - Fax:908-595-1325
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2007-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA67689207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7902107Medicaid
NJ7902107Medicaid
NJ017256Medicare PIN