Individual
DR. TIMOTHY JAMES WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
845 CENTRAL AVE STE 1, ALBANY, NY 12206-1514
(518) 729-3953
Mailing address
845 CENTRAL AVE STE 1, ALBANY, NY 12206-1514
(518) 729-3953
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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