Individual
ROBERT S WIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
286 E MAIN ST, SOMERVILLE, NJ 08876-3006
(908) 231-1999
(908) 231-1612
Mailing address
25 PORT IMPERIAL, WEST NEW YORK, NJ 07093-8302
(201) 601-0772
(908) 231-1612
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
25MA07943500
NJ
Other
Enumeration date
05/20/2006
Last updated
02/24/2010
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