Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 245804 | NY |
N | 111NI0900X | Internist | 245804 | NY |
Y | 2080P0201X | Pediatric Allergist | 0101247902 | VA |
NPI | 1205095593 |
---|---|
Provider Name | Julia A. Wisniewski |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22908-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 12/06/2012 |