Individual
JOSEPH G WIEDERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 RIVERSIDE DR APT 310, NEW YORK, NY 10025-4116
(917) 940-4076
(212) 662-0375
Mailing address
310 RIVERSIDE DR APT 310, NEW YORK, NY 10025-4116
(917) 940-4076
(212) 662-0375
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
25MA06221700
NJ
207RI0011X
Interventional Cardiology Physician
25MA06221700
NJ
207RI0011X
Interventional Cardiology Physician
Primary
M-2082
GU
207RI0011X
Interventional Cardiology Physician
MTL-2017-072
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01177233
—
NY
05
—
6589502
—
NJ
05
—
H110329
—
GU
Enumeration date
07/08/2006
Last updated
12/07/2021
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