Organization
RENEW WOUND CARE OF NEW MEXICO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH WIESENFELD (ADMINISTRATOR)
(718) 408-8860
Entity
Organization
Contact information
Practice address
5900 FOREST HILLS DR NE, ALBUQUERQUE, NM 87109-4129
(718) 408-8860
Mailing address
1481 MCDONALD AVE, BROOKLYN, NY 11230-4667
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
10/25/2022
Last updated
06/27/2023
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