Active NPI
Bonnie Wiesner, PHD
- Psychologist
- Ramsey, NJ
National Provider Identifier
1457371296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35S100286200
- Practice address
- 7 Knollwood Drive
Ramsey, NJ 07416 - Phone
- (201) 825-0528
- NPI assigned
- Jul 21, 2006
- Last updated
- Nov 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35S100286200 | NJ | Primary |
| Psychologist | 103T00000X | 010679 | NY |
Addresses
Primary practice location
7 Knollwood Drive
Ramsey, NJ 07416
Mailing address
7 Knollwood Drive
Ramsey, NJ 07416
Phone (201) 825-0528
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 9, 2015 through Oct 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35S100286200 | NJ | MD | Psychologist |
| 010679 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288742400000",
"number": "1457371296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 KNOLLWOOD DRIVE",
"city": "RAMSEY",
"state": "NJ",
"postal_code": "07416",
"telephone_number": "201-825-0528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 KNOLLWOOD DRIVE",
"city": "RAMSEY",
"state": "NJ",
"postal_code": "07416",
"telephone_number": "201-825-0528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIESNER",
"first_name": "BONNIE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-21",
"last_updated": "2010-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35S100286200",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "010679",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ramsey, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.