Individual
JAMES L WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
78 MAIDEN LN, KINGSTON, NY 12401-4508
(845) 331-5326
(845) 331-5837
Mailing address
78 MAIDEN LN, KINGSTON, NY 12401-4508
(845) 331-5326
(845) 331-5837
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
133354
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00695661
—
NY
01
—
100319637662
CDPHP
—
01
—
158564
WELLCARE
—
01
—
367114
MVP
—
01
—
50649
GHI
—
01
—
66A521
BLUE CROSS
—
Enumeration date
06/22/2006
Last updated
10/23/2014
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