Individual
ROBERT WICELINSKI JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
600 ROE AVE, ELMIRA, NY 14905-1629
(607) 737-4508
(607) 735-5738
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
(607) 873-1244
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
277455
NY
207Q00000X
Family Medicine Physician
277455
NY
207QA0401X
Addiction Medicine (Family Medicine) Physician
277455
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04665532
—
NY
Enumeration date
12/18/2012
Last updated
11/12/2025
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