Individual
RENEE LYN WISNISKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1402
(718) 470-7660
Mailing address
77 JUNIPER RD FL 2, PORT WASHINGTON, NY 11050-1451
(516) 603-1361
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
420718
NY
367A00000X
Advanced Practice Midwife
Primary
002181
NY
Other
Enumeration date
03/20/2007
Last updated
11/17/2022
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