| NPI | 1992582183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WIESENFELD Practice Administrator 718-408-8860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-09-11 |