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Individual

NOEL WIEDERHORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
43 YAWPO AVE, OAKLAND, NJ 07436-2714
(201) 405-0500
(201) 337-5585
Mailing address
870 PALISADE AVE, STE 204, TEANECK, NJ 07666-3419
(201) 928-1093
(201) 928-0842

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA02569900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1414801
NJ
Enumeration date
08/09/2005
Last updated
01/18/2013
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