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Individual

MARILYN A WYSOCKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1870 GRAND CONCOURSE, BRONX, NY 10457
(718) 299-5000
Mailing address
210 MCADOO AVE, JERSEY CITY, NJ 07305
(718) 299-5000

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
145601
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00843325
NY
Enumeration date
09/22/2006
Last updated
07/08/2007
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