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Individual

DR. CHRIS WILDENAUER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2137 JACKSON AVE, SEAFORD, NY 11783-2605
(516) 781-1018
(516) 679-2589
Mailing address
2137 JACKSON AVE, SEAFORD, NY 11783-2605
(516) 781-1018
(516) 679-2589

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X009813
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00318049
RAIL ROAD MEDICARE
NY
01
P2115919
OXFORD ID NUMBER
NY
Enumeration date
09/26/2006
Last updated
09/26/2017
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