Healthcare Provider Details

I. General information

NPI: 1104350776
Provider Name (Legal Business Name): ASHER WIEDERKEHR DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 RICHMOND AVE
STATEN ISLAND NY
10314-3940
US

IV. Provider business mailing address

3714 AVENUE P
BROOKLYN NY
11234-3426
US

V. Phone/Fax

Practice location:
  • Phone: 718-556-5550
  • Fax: 718-556-7868
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN007093
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: