Individual
DR. JOHN D WILGUCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1500 SAINT GEORGES AVE, UNIT D, AVENEL, NJ 07001-1000
(732) 388-3030
(732) 388-3528
Mailing address
1500 SAINT GEORGES AVE, UNIT D, AVENEL, NJ 07001-1000
(732) 388-3030
(732) 388-3528
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MB56000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123015
AETNA PROVIDER NUMBER
—
05
—
5805802
—
NJ
Enumeration date
01/03/2007
Last updated
12/14/2007
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