Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 190935 | NY |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD034399E | PA |
N | 207VG0400X | Gynecologist | 190935 | NY |
N | 207VG0400X | Gynecologist | MD034399E | PA |
NPI | 1255398079 |
---|---|
Provider Name | Barbara L Wiseman |
First Address | Sayre, PA 18840-1625 |
Second Address | Sayre, PA 18840-1625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 11/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01241143 | (05) | NY |
B41561 | (02) |