Individual
DR. TIMOTHY JAMES WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
017817
NY
103TA0700X
Adult Development & Aging Psychologist
017817
NY
103TB0200X
Cognitive & Behavioral Psychologist
017817
NY
103TC0700X
Clinical Psychologist
017817
NY
103TF0000X
Family Psychologist
017817
NY
103TF0200X
Forensic Psychologist
Primary
017817
NY
103TP2701X
Group Psychotherapy Psychologist
017817
NY
Other
Enumeration date
03/28/2020
Last updated
03/28/2020
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