Individual
DR. NIYA WANICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
216 ENGLE ST, SUITE 101, ENGLEWOOD, NJ 07631-2444
(201) 816-9800
(201) 567-1569
Mailing address
216 ENGLE STREET, SUITE 101, ENGLEWOOD, NJ 07631
(201) 816-9800
(201) 567-1569
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
104650
CA
207K00000X
Allergy & Immunology Physician
Primary
230693
NY
Other
Enumeration date
08/10/2007
Last updated
10/06/2016
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