Dr. Michael J Wiener
Periodontist
921 State St
New Haven
, Connecticut 06511-3926
Dr. Michael J Wiener
Periodontist
921 State St
New Haven
, Connecticut 06511-3926
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Michael J Wiener
- 140 Alston Ave
- New Haven, CT
- Zip : 06515-2002
- Phone :
Second Address
- Dr. Michael J Wiener
- 921 State St
- New Haven, CT
- Zip : 06511-3926
- Phone : (203) 865-2245
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 008178 | CT |
National Provider Identifier
| NPI | 1013053271 |
|---|---|
| Provider Name | Dr. Michael J Wiener |
| First Address | New Haven, CT 06515-2002 |
| Second Address | New Haven, CT 06511-3926 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/01/2007 |
| Last Update Date | 05/05/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 008001172 | (05) | CT |
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.