Individual
DR. ALAN JONAH WIEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 ROCKAWAY TPKE, LAWRENCE, NY 11559-1216
(516) 374-5024
Mailing address
215 ROCKAWAY TPKE, LAWRENCE, NY 11559-1216
(516) 374-5024
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
202090
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01715351
—
NY
Enumeration date
03/06/2007
Last updated
10/08/2014
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