Wieting, Richard John

Wieting, Richard John is an individual health care provider with primary practice located at 116 Terryville Rd , Port Jefferson Station NY 11776-1329. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wieting, Richard John can be contacted via phone (631) 928-2002.

Contact Information

Primary practice address
116 Terryville Rd Port Jefferson Station NY 11776-1329
Phone: (631) 928-2002
Fax: (631) 928-4934
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 225618 New York

Profile Details

NPI number 1639158678
LBN Legal business name Wieting, Richard John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Jul 8th, 2007 - about 17 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 1639158678 NPPES
New York MEDICAID 02313720

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