MEDICARE: DR. JAMES R WILENTZ M.D.

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	207RC0000X	Cardiovascular Disease Physician	165980	NY
2	207RI0011X	Interventional Cardiology Physician	165980	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467446070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES R WILENTZ M.D.

Provider Business Mailing Address
First Line	:	10 UNION SQ E
Second Line	:	STE 5M1
City	:	NEW YORK
State	:	NY
Zip	:	10003-3314
Country	:	US
Telephone Number	:	212-253-6800
Fax Number	:	212-253-6100

Provider Business Practice Location Address
First Line	:	10 UNION SQ. E.
Second Line	:	STE 5M1
City	:	NEW YORK
State	:	NY
Zip	:	10003-3314
Country	:	US
Telephone Number	:	212-253-6800
Fax Number	:	212-253-6100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	07/01/2015

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