MEDICARE: JONATHAN WIESEN MD PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1174274856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONATHAN WIESEN MD PLLC

Provider Business Mailing Address
First Line	:	1075 STEPHENSON AVE STE D2
Second Line	:
City	:	OCEANPORT
State	:	NJ
Zip	:	07757-1242
Country	:	US
Telephone Number	:	833-223-2266
Fax Number	:	732-329-2322

Provider Business Practice Location Address
First Line	:	668 N FOREST DR
Second Line	:
City	:	TEANECK
State	:	NJ
Zip	:	07666-2047
Country	:	US
Telephone Number	:	201-564-4890
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JONATHAN WIESEN
Credential	:	MD
Telephone Number	:	201-564-4890

Provider Enumeration Date	:	01/13/2022
Last Update Date	:	08/07/2023

Similar Medicare Providers

1003455072 — J MEDICAL PRACTICE LLC
Practice Location Address:

668 N FOREST DR
TEANECK, NJ
07666-2047

Practice Phone: 201-564-4890
Practice Fax:

1306041918 — TALAL MAHMOOD M.D.
Practice Location Address:

870 PALISADE AVE STE 202
TEANECK, NJ
07666-3445

Practice Phone: 551-996-9189
Practice Fax: 201-836-8042

1558178939 — SARA F SHOSHANA
Practice Location Address:

1500 TEANECK RD APT 419
TEANECK, NJ
07666-3659

Practice Phone: 973-767-9883
Practice Fax:

1871449413 — ERYN CLARISE VILLANUEVA
Practice Location Address:

1000 RIVER RD
TEANECK, NJ
07666-1938

Practice Phone: 201-692-2000
Practice Fax:

1902752553 — EMILY MARISSA WOLLENBERG
Practice Location Address:

312 BEECH ST
TEANECK, NJ
07666-4021

Practice Phone: 201-779-7246
Practice Fax:

1306792809 — AMBER V TORRES CCC-SLP
Practice Location Address:

1104 TEANECK RD
TEANECK, NJ
07666-4800

Practice Phone: 201-833-2400
Practice Fax:

Directions to “JONATHAN WIESEN MD PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.