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Individual

DR. ELLEN BARBARA WETTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
227 MADISON ST, NEW YORK, NY 10002-7537
(212) 238-7512
Mailing address
196 E 75TH ST APT 21C, NEW YORK, NY 10021-3266
(212) 535-2557

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
158090
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00946438
NY
Enumeration date
07/18/2006
Last updated
07/23/2009
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