Individual
DR. IRA EMANUEL WISOTZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
151 KNOLLCROFT RD, MENTAL HEALTH AND BEHAVIORAL SCIENCE, LYONS, NJ 07939-5001
(908) 647-0180
Mailing address
32 CRABAPPLE PL, NEWTOWN, PA 18940-9281
(215) 968-3906
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
0111941
NY
103TC0700X
Clinical Psychologist
Primary
35S100286300
NJ
103TC0700X
Clinical Psychologist
PS015502
PA
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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