Individual
ROBERT WICKIEWICZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 RIVER ST, VALATIE, NY 12184-9694
(518) 748-7736
Mailing address
PO BOX 1123, LATHAM, NY 12110-0079
(800) 357-4829
(518) 786-1293
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
114150
NY
Other
Enumeration date
10/31/2005
Last updated
07/08/2007
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