Individual
DR. SHIMSHON WIESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
360 CENTRAL AVE STE 113, LAWRENCE, NY 11559-1604
(516) 569-6966
Mailing address
360 CENTRAL AVE STE 113, LAWRENCE, NY 11559-1604
(516) 569-6966
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
296931
NY
207RP1001X
Pulmonary Disease Physician
Primary
296931
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/27/2015
Last updated
06/17/2022
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