Individual
ANNIE WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
234 E 149TH ST, 5C-ROOM 337, BRONX, NY 10451
(718) 579-6476
Mailing address
424 ROSLYN, WESTMOUNT, QC H3Y2T-5
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NY
Other
Enumeration date
05/08/2024
Last updated
11/26/2024
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