Wiseman, Gloria Diana
Wiseman, Gloria Diana is an individual health care provider with primary practice located at 570 Fort Washington Ave , New York NY 10033-2054. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Wiseman, Gloria Diana can be contacted via phone (212) 795-3293.Contact Information
Primary practice address
570 Fort Washington Ave
New York NY 10033-2054
Phone: (212) 795-3293
Fax: (212) 795-3164
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 151187 | New York |
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | MA47936 | New Jersey |
Profile Details
| NPI number | 1821162801 |
|---|---|
| LBN Legal business name | Wiseman, Gloria Diana |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821162801 | NPPES |
| New York | MEDICAID | 00848417 | |
| New York | MEDICAID | 5114900 |
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