Provider Demographics
NPI:1508375353
Name:NEW GW LLC
Entity Type:Organization
Organization Name:NEW GW LLC
Other - Org Name:THE WITLIN CENTER FOR ADVANCED EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:GERSHENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-431-9333
Mailing Address - Street 1:385 ROUTE 18 STE H
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5703
Mailing Address - Country:US
Mailing Address - Phone:732-698-9300
Mailing Address - Fax:732-254-0786
Practice Address - Street 1:385 ROUTE 18
Practice Address - Street 2:UNIT H
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5703
Practice Address - Country:US
Practice Address - Phone:732-698-9300
Practice Address - Fax:732-254-0786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07781000207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty