| Wien Medical Group Llc | |
|
625 Broadway Paterson NJ 07514-1977 | |
| (973) 742-2228 | |
| (201) 265-7078 |
| Full Name | Wien Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 625 Broadway, Paterson, New Jersey |
| Authorized Official Name and Position | Frederic E Wien (OWNER) |
| Authorized Official Contact | 2012657001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wien Medical Group Llc 625 Broadway Paterson NJ 07514-1977 Ph: (973) 742-2228 | Wien Medical Group Llc 625 Broadway Paterson NJ 07514-1977 Ph: (973) 742-2228 |
| NPI Number | 1417145012 |
|---|---|
| Provider Enumeration Date | 10/09/2007 |
| Last Update Date | 04/23/2010 |
| Medicare PECOS PAC ID | 0648307850 |
|---|---|
| Medicare Enrollment ID | O20100420000702 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417145012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Frederic Wien |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639141054 PECOS PAC ID: 5496728685 Enrollment ID: I20040816001397 |
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