Wisniewski, Susan

Wisniewski, Susan is an individual health care provider with primary practice located at 1110 South Ave Suite 306, Staten Island NY 10314-3403. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Wisniewski, Susan can be contacted via phone (718) 370-7100.

Contact Information

Primary practice address
1110 South Ave Suite 306 Staten Island NY 10314-3403
Phone: (718) 370-7100
Fax: (718) 370-7141
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 222866 New York

Profile Details

NPI number 1629047675
LBN Legal business name Wisniewski, Susan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Dec 1st, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629047675 NPPES
New York MEDICAID 02593328

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