Individual
CARLA JEAN WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
263 BLUE POINT AVE, BLUE POINT, NY 11715-1224
(866) 794-1644
Mailing address
35 RYERSON AVE, MANORVILLE, NY 11949-2409
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
615223
NY
Other
Enumeration date
03/26/2019
Last updated
03/26/2019
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