Individual
DR. TODD M WIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
871 5TH AVENUE, NEW YORK, NY 10023
(212) 772-1229
(212) 737-8569
Mailing address
48 ROUTE 25A, 202, SMITHTOWN, NY 11787-1431
(631) 862-3625
(631) 862-3347
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
193602
NY
Other
Enumeration date
11/04/2006
Last updated
02/18/2009
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