Individual
FRUMA LEAH WIEDERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1800 ROCKAWAY AVE, HEWLETT, NY 11557-1665
(516) 887-4335
Mailing address
1800 ROCKAWAY AVE, HEWLETT, NY 11557-1665
(516) 887-4335
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
013097
NY
363A00000X
Physician Assistant
093097
NY
Other
Enumeration date
05/11/2009
Last updated
03/08/2021
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