Individual
JEREMY B WIYGUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11205 QUEENS BLVD, FOREST HILLS, NY 11375-8311
(718) 224-2644
Mailing address
11205 QUEENS BLVD, FOREST HILLS, NY 11375-8311
(718) 224-2644
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
233198
MA
2088P0231X
Pediatric Urology Physician
Primary
257056
NY
Other
Enumeration date
07/25/2007
Last updated
06/21/2023
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