Individual
MR. MICHAEL JOSEPH WISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
523 TOWNLINE RD STE 5, HAUPPAUGE, NY 11788-2827
(631) 974-3229
(631) 759-5521
Mailing address
4 WICKS DR, COMMACK, NY 11725-3922
(631) 974-3229
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400339
NY
Other
Enumeration date
08/13/2005
Last updated
02/18/2022
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