Individual
ELIZABETH WIESNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
240 INDIAN RIVER RD, SUITE B-1, ORANGE, CT 06477-3649
(203) 795-4924
(203) 799-1554
Mailing address
240 INDIAN RIVER RD, SUITE B-1, ORANGE, CT 06477-3649
(203) 795-4924
(203) 799-1554
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
023395
CT
Other
Enumeration date
08/29/2006
Last updated
01/17/2014
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