Individual
GARY B WENICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2050 ROUTE 22, SUITE 101, BREWSTER, NY 10509-5948
(845) 279-2323
(845) 278-2341
Mailing address
2050 ROUTE 22, SUITE 101, BREWSTER, NY 10509-5948
(845) 279-2323
(845) 278-2341
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
162047
NY
2080P0205X
Pediatric Endocrinology Physician
162047
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01251234
—
NY
Enumeration date
11/09/2006
Last updated
03/16/2016
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