Organization
JEFFREY B. WISE, M.D., L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY BRUCE WISE M.D. (MANAGING MEMBER)
(973) 305-1400
Entity
Organization
Contact information
Practice address
1680 ROUTE 23, SUITE 100, WAYNE, NJ 07470-7501
(973) 305-1400
(973) 694-5580
Mailing address
1680 ROUTE 23, SUITE 100, WAYNE, NJ 07470-7501
(973) 305-1400
(973) 694-5580
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
25M08257300
NJ
Other
Enumeration date
10/09/2007
Last updated
10/09/2007
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