Provider Demographics
NPI:1215996012
Name:WINTERS, RICHARD MARK (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MARK
Last Name:WINTERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20 PROSPECT AVE
Mailing Address - Street 2:STE 501
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:201-487-3400
Mailing Address - Fax:201-603-1993
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:STE 501
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:201-487-3400
Practice Address - Fax:201-603-1993
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2024-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA67Y03208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G75679Medicare ID - Type Unspecified