Individual
DR. DARYL WIELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1400 PELHAM PARKWAY S, BOLD 1 3 WEST6A, BRONX, NY 10461
(718) 918-5443
(718) 918-6787
Mailing address
8 PEPPERCORN PL, BEDFORD, NY 10506-2209
(718) 918-3060
(718) 918-4469
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
201511-1
NY
207VG0400X
Gynecology Physician
201511
NY
2083C0008X
Clinical Informatics Physician
201511
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01961999
—
NY
01
—
49044
CT STATE LICENSE
CT
Enumeration date
10/12/2006
Last updated
07/21/2022
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