Individual
MR. DANIEL R WIEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPAC
Contact information
Practice address
11835 RT 9W, WEST COXSACKIE, NY 12192-3605
(518) 731-9000
(518) 731-9119
Mailing address
11835 RT 9W, WEST COXSACKIE, NY 12192-3605
(518) 731-9000
(518) 731-9119
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0039611
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000406870004
BLUE SHIELD NENY
—
01
—
10050348
CDPHP
—
01
—
275191
WELLCARE NY
—
01
—
4937930001
MEDICARE DME
NY
01
—
DW05762L10
BLUE CROSS
—
Enumeration date
01/18/2006
Last updated
01/22/2008
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