Janet Widerspan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

209672 Issued in NY

Practice address

50 Larch LN
Massapequa Park, NY 11762-3924

Phone

(516) 804-4899

NPI assigned

Apr 23, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1659698199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 212",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117620212",
            "telephone_number": "516-804-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LARCH LN",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117623924",
            "telephone_number": "516-804-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDERSPAN",
        "first_name": "JANET",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "209672",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A64617",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K3658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Watson, SLP
• Wavelengths Psychology, PC
• Laura Jean Weigand, PTA
• Roberta Whitefield
• Janet Whyte
• Derrick Williams
• Lauren Williams
• Rachel Williams
• Marshall Winkler, MS,ED.
• Winthrop Faculty Medical Affiliates University Faculty Practice Corpor

• Family Medicine Physician in Massapequa Park, NY
• Providers in Massapequa Park, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.