Individual
MS. COLLEEN M. WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.B.O.C. OPTICIAN
Contact information
Practice address
10101 COLESVILLE RD, SILVER SPRING, MD 20901-2426
(301) 754-0101
(301) 754-0103
Mailing address
10101 COLESVILLE RD, SILVER SPRING, MD 20901-2426
(301) 754-0101
(301) 754-0103
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992121669
GROUP NPI
MD
Enumeration date
11/22/2016
Last updated
01/17/2017
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