Provider Demographics
NPI:1114092236
Name:WINTERS, RICHARD A (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:WINTERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 N FARVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2738
Mailing Address - Country:US
Mailing Address - Phone:201-843-4944
Mailing Address - Fax:201-265-7647
Practice Address - Street 1:29 NORTH FARVIEW AVENUE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2717
Practice Address - Country:US
Practice Address - Phone:201-843-4944
Practice Address - Fax:201-265-7647
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0279022084P0800X
NY1163882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1512005Medicaid
NJ452307Medicare PIN
NJ1512005Medicaid