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Individual
MS. MARY IZZO WIGHT
Active
Individual
MS. MARY IZZO WIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, RN, BSN, LAC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
664500
NY
171100000X
Acupuncturist
25003048
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403071
NY
Other
Enumeration date
01/03/2007
Last updated
10/21/2020
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