Dr. Mark Wiesen
Endocrinologist (Diabetes Doctor)
870 Palisade Ave Suite 203
Teaneck
, New Jersey 07666-3419
Dr. Mark Wiesen
Endocrinologist (Diabetes Doctor)
870 Palisade Ave Suite 203
Teaneck
, New Jersey 07666-3419
(201) 836-5655
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About
Features
Specialties
- Endocrinologist (Diabetes Doctor)
Languages spoken
- English
Location
First Address
- Dr. Mark Wiesen
- 870 Palisade Ave Suite 203
- Teaneck, NJ
- Zip : 07666-3419
- Phone : (201) 836-5655
Second Address
- Dr. Mark Wiesen
- 870 Palisade Ave Suite 203
- Teaneck, NJ
- Zip : 07666-3419
- Phone : (201) 836-5655
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | MA39387 | NJ |
National Provider Identifier
| NPI | 1053367912 |
|---|---|
| Provider Name | Dr. Mark Wiesen |
| First Address | Teaneck, NJ 07666-3419 |
| Second Address | Teaneck, NJ 07666-3419 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/05/2006 |
| Last Update Date | 31/12/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0712507 | (05) | NJ |
| C52950 | (02) | NJ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.