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1386332401
ELLIE WIESE
STATEN ISLAND, NY
NPI
1386332401
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2023-04-26
Last Update Date
2023-04-26
Business Address
ELLIE WIESE
1 CAMPUS RD
STATEN ISLAND, NY 10301-4479
Phone number: 718-390-3100
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Mailing Address
ELLIE WIESE
1 CAMPUS RD
STATEN ISLAND, NY 10301-4479
Phone number: 718-420-4142
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