Organization
J MEDICAL PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN WIESEN MD (OWNER)
(201) 564-4890
Entity
Organization
Contact information
Practice address
668 N FOREST DR, TEANECK, NJ 07666-2047
(201) 564-4890
Mailing address
668 N FOREST DR, TEANECK, NJ 07666-2047
(551) 486-6214
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
12/23/2019
Last updated
08/07/2023
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