Individual
DR. MAJ L WICKSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
560 1ST AVE, NEW YORK, NY 10016-6402
(212) 263-0050
Mailing address
24 STONEWALL CIR, WEST HARRISON, NY 10604-1117
(914) 428-3223
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
225207
NY
Other
Enumeration date
04/27/2006
Last updated
10/24/2011
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