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Individual

DR. CHARLES WIDESKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
975 STEWART AVE, GARDEN CITY, NY 11530-4816
(516) 222-8688
(516) 745-5476
Mailing address
975 STEWART AVE, GARDEN CITY, NY 11530-4816
(516) 222-8688
(516) 745-5476

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
143739
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01710109
NY
Enumeration date
05/05/2006
Last updated
04/02/2021
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