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1639158678
RICHARD JOHN WIETING
PORT JEFFERSON STATION, NY
NPI
1639158678
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NY 225618)
Enumeration Date
2006-01-10
Last Update Date
2007-07-08
Business Address
Dr. RICHARD JOHN WIETING M.D.
116 TERRYVILLE RD
PORT JEFFERSON STATION, NY 11776-1329
Phone number: 631-928-2002
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Mailing Address
Dr. RICHARD JOHN WIETING M.D.
38 ROLLING RD
MILLER PLACE, NY 11764-2217
Phone number: 631-331-0633
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