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Individual

DR. JEFFREY S WISCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2014 WASHINGTON ST, VERNON CANCER CENTER, NEWTON, MA 02462-1607
(617) 658-6000
(617) 658-6001
Mailing address
2014 WASHINGTON ST, VERNON CANCER CENTER, NEWTON, MA 02462-1607
(617) 658-6000
(617) 658-6001

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
45726
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0162973
MA
Enumeration date
03/01/2006
Last updated
10/05/2009
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