Individual
EDYTA KINGA WISNIEWSKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
173 FORT WASHINGTON AVE, NEW YORK, NY 10032-3739
(212) 305-2500
Mailing address
32 SPRING ST APT 120, WALLINGTON, NJ 07057-2030
(551) 795-3024
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
26NR16881300
NJ
163WC0200X
Critical Care Medicine Registered Nurse
715683-1
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
715683-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W46691947256904
DRIVER'S LICENSE
NJ
Enumeration date
06/18/2017
Last updated
10/03/2019
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