Individual
LISA SILVIA WIECHMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
161 FORT WASHINGTON AVE FL 10, NEW YORK, NY 10032-3729
(212) 305-9676
(212) 305-1522
Mailing address
161 FORT WASHINGTON AVE FL 10, NEW YORK, NY 10032-3729
(212) 305-9676
(212) 305-1522
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
249341
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03135577
—
NY
01
—
A400167592
NY MEDICARE PTAN
NY
01
—
P01822802
RAIL ROAD MEDICARE
NY
Enumeration date
06/10/2008
Last updated
03/07/2023
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