Wideska, Charles

Wideska, Charles is an individual health care provider with primary practice located at 975 Stewart Ave , Garden City NY 11530-4816. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Wideska, Charles can be contacted via phone (516) 222-8688.

Contact Information

Primary practice address
975 Stewart Ave Garden City NY 11530-4816
Fax: (516) 745-5476
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 143739 New York

Profile Details

NPI number 1982652319
LBN Legal business name Wideska, Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Apr 2nd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982652319 NPPES
New York MEDICAID 01710109

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