Individual
TONY WANICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
535 E 70TH ST, NEW YORK, NY 10021-4898
(212) 606-1392
(917) 260-4392
Mailing address
535 E 70TH ST, NEW YORK, NY 10021-4898
(212) 606-1392
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
230560
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
25MA08680200
NJ
Other
Enumeration date
05/31/2007
Last updated
05/31/2022
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