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General NPI Number Information
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NPI Number | 1629197223
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Entity Type | Organization
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Legal Business Name | PETER WISCH M.D. P.C.
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 55 E 87TH ST SUITE 1E
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City | NEW YORK
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State | NY
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Zip | 10128-1043
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Country | US
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Telephone | 212-369-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 55 E 87TH ST SUITE 1E
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City | NEW YORK
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State | NY
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Zip | 10128-1043
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Country | US
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Telephone | 212-369-6900
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS PATRICIA AGUIRRE
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Credential |
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Telephone | 212-369-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 165551-1
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License Number State | NY
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