Individual
CHANY WIEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
74 PENN ST, BROOKLYN, NY 11249-7810
(718) 243-9378
Mailing address
74 PENN ST, BROOKLYN, NY 11249-7810
(718) 243-9378
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1185156
NY
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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