Healthcare Provider Details

I. General information

NPI: 1487821658
Provider Name (Legal Business Name): WISSAM HOYEK MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 01/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 MASON AVE
STATEN ISLAND NY
10305-3417
US

IV. Provider business mailing address

948 TODT HILL RD
STATEN ISLAND NY
10304-1318
US

V. Phone/Fax

Practice location:
  • Phone: 718-351-3933
  • Fax: 718-351-2897
Mailing address:
  • Phone: 718-987-8839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number233686
License Number StateNY

VIII. Authorized Official

Name: MRS. ROXANA PEEKE
Title or Position: BILLING
Credential:
Phone: 201-522-3205