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General NPI Number Information
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NPI Number | 1124134044
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Entity Type | Individual
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Provider Name | JOSEPH M WISIENSKI CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 2500 BERNVILLE RD
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City | READING
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State | PA
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Zip | 19605-9453
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Country | US
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Telephone | 610-378-2055
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Fax | 610-378-2058
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Provider Business Mailing Address
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Address Line | PO BOX 13579
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City | READING
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State | PA
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Zip | 19612-3579
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Country | US
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Telephone | 484-628-0799
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Fax | 484-334-7026
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN320886L
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License Number State | PA
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