Individual
LAUREN ELIZABETH TAKEKO WISNIOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-3480
Mailing address
3601 MARKET ST UNIT 2412, PHILADELPHIA, PA 19104-5921
(808) 348-7473
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
SP026698
PA
Other
Enumeration date
01/02/2023
Last updated
06/02/2025
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