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Organization

AGILE INFUSION MEDICINE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JONATHAN WIESEN MD (OWNER)
(631) 759-9866
Entity
Organization

Contact information

Practice address
5 SUMMIT AVE STE 204, HACKENSACK, NJ 07601-1271
(201) 751-2202
(201) 266-0437
Mailing address
668 N FOREST DR, TEANECK, NJ 07666-2047
(201) 751-2202

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
261QP2300X
Primary Care Clinic/Center
Primary

Other

Enumeration date
09/27/2023
Last updated
12/06/2023
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