Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 25MD00296900 | NJ |
NPI | 1063673036 |
---|---|
Provider Name | Dr. Cheryl Wisniewski |
First Address | Woodbury Heights, NJ 08097-1141 |
Second Address | Woodbury Heights, NJ 08097-1141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2008 |
Last Update Date | 22/06/2008 |