Individual
DANA WIGHTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
65 W JIMMIE LEEDS RD, POMONA, NJ 08240
(609) 441-8146
(609) 441-8002
Mailing address
65 W JIMMIE LEEDS RD, POMONA, NJ 08240-9102
(609) 441-8146
(609) 441-8002
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA 9108751
FL
363AS0400X
Surgical Physician Assistant
Primary
25MP00475400
NJ
363AS0400X
Surgical Physician Assistant
PA9108751
FL
Other
Enumeration date
07/07/2015
Last updated
09/05/2018
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