Organization
EMPIRE WOUND PHYSICIAN SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILANA WEISBERG (DIRECTOR OF FINANCE)
(216) 534-1775
Entity
Organization
Contact information
Practice address
170 LAKE ST, LIBERTY, NY 12754-1966
(216) 273-9800
(216) 273-9998
Mailing address
6150 PARKLAND BLVD STE 225, MAYFIELD HEIGHTS, OH 44124-4103
(216) 273-9800
(216) 273-9998
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04025343
—
NY
Enumeration date
03/04/2014
Last updated
12/08/2023
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