Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
MISS MONIQUE J WISE
Active
Individual
MISS MONIQUE J WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
018391-1
NY
363AS0400X
Surgical Physician Assistant
018391-1
NY
Other
Enumeration date
04/16/2015
Last updated
01/19/2017
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