MEDICARE: HEALTHWISE MEDICAL ASSOCIATES, PC

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	207RN0300X	Nephrology Physician	190077	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P618936	OTHER	NY	OXFORD
2	178149	OTHER	NY	ELDER PLAN
3	110194494	OTHER	NY	UHC RAILROAD
4	2C6442	OTHER	NY	HEALTH NET
5	1530402	OTHER	NY	UNITEDHEALTHCARE
6	433056NA	OTHER	NY	CIGNA
7	31N253	OTHER	NY	EMPIRE
8	3300180	OTHER	NY	GHI
9	085AS2	OTHER	NY	EMPIRE
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	085AS3	OTHER	NY	EMPIRE

General Provider Information

NPI Number	:	1578698742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHWISE MEDICAL ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	401 E 34TH ST
Second Line	:	SUITE SOUTH 35D
City	:	NEW YORK
State	:	NY
Zip	:	10016-4914
Country	:	US
Telephone Number	:	212-686-5782
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 E 34TH ST
Second Line	:	SUITE SOUTH 35D
City	:	NEW YORK
State	:	NY
Zip	:	10016-4914
Country	:	US
Telephone Number	:	212-686-5782
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DOMINIC EMEKA ONYEMA
Credential	:	M.D.
Telephone Number	:	212-686-5782

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	11/05/2007

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