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1295045706
MARK WIELGUS
GLEN COVE, NY
NPI
1295045706
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: NY 009602)
Enumeration Date
2010-10-18
Last Update Date
2010-10-18
Business Address
-- MARK WIELGUS PH.D.
141 DOSORIS LN
GLEN COVE, NY 11542-1225
Phone number: 516-676-1100
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Mailing Address
-- MARK WIELGUS PH.D.
303 MERRICK RD SUITE 204
LYNBROOK, NY 11563-2501
Phone number: 800-725-6280
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