Individual
HEATHER WILANTEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
142 S MONTGOMERY ST, WALDEN, NY 12586-1601
(845) 778-5811
(845) 778-5564
Mailing address
142 S MONTGOMERY ST, WALDEN, NY 12586-1601
(845) 778-5811
(845) 778-5564
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007210
NY
Other
Enumeration date
03/08/2007
Last updated
06/04/2008
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