Wiedaseck, Susan

Wiedaseck, Susan is an individual health care provider with primary practice located at 201 Lyons Ave , Newark NJ 07107. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Wiedaseck, Susan can be contacted via phone (973) 972-4249.

Contact Information

Primary practice address
201 Lyons Ave Newark NJ 07107
Phone: (973) 972-4249
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 25ME00013401 New Jersey

Profile Details

NPI number 1720049406
LBN Legal business name Wiedaseck, Susan
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Jul 8th, 2007 - about 18 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 1720049406 NPPES
New Jersey MEDICAID 2094207

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