Individual
ELLIOT WIESENFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 ROCKWOOD PL STE 440, ENGLEWOOD, NJ 07631-4987
(201) 568-3690
Mailing address
25 ROCKWOOD PL STE 440, ENGLEWOOD, NJ 07631-4987
(201) 568-3690
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
25MA11791000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0917061
—
NJ
Enumeration date
03/06/2015
Last updated
11/07/2023
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