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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. MARC E WIETSCHNER, M.D.

Active Sole Proprietor

DR. MARC E WIETSCHNER, M.D. is a Sports Medicine (Emergency) healthcare provider located in FLORAL PARK, New York. NPI 1477555829 is currently active in the NPPES registry. Verify at CMS.

Sports Medicine (Emergency) · FLORAL PARK, NY

Registration Details

NPI Number
1477555829
Provider Type
Individual
Gender
Male
NPI Issued
Aug 15, 2005 (21.043782672134 yrs)
Last Updated
Jan 29, 2018
Licenses
186943 (NY)
186943 (NY)
Sole Proprietor
Yes

Practice Information

Address
342 JERICHO TPKE
FLORAL PARK, NY, 110012108
Browse NY providers · Browse ZIP 11001
Phone
5163542020
Fax
5163540400
Primary Specialty
Sports Medicine (Emergency)
207WX0107X
Additional Specialty
Sports Medicine (Emergency)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.