Provider Demographics
NPI:1750472171
Name:RONALD MINZTER, MD PC
Entity type:Organization
Organization Name:RONALD MINZTER, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:YANKOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-577-5558
Mailing Address - Street 1:495 IRON BRIDGE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3069
Mailing Address - Country:US
Mailing Address - Phone:732-577-5558
Mailing Address - Fax:732-577-5559
Practice Address - Street 1:495 IRON BRIDGE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3069
Practice Address - Country:US
Practice Address - Phone:732-577-5558
Practice Address - Fax:732-577-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA055860300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU78745Medicare UPIN