Healthcare Provider Details

I. General information

NPI: 1629186721
Provider Name (Legal Business Name): WISSAM HOYEK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
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
10305
US

V. Phone/Fax

Practice location:
  • Phone: 718-351-3933
  • Fax: 718-351-2897
Mailing address:
  • Phone: 201-522-3205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number233686
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number233686
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: