Carl M. Wiesenthal, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

129216 Issued in NY

Practice address

78 Todt Hill Rd
Suite 204
Staten Island, NY 10314-4528

Phone

(718) 273-2626

Fax

(718) 442-4295

NPI assigned

Nov 29, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Richmond Otolaryngology Group PC

  • Otolaryngology Physician
  • Staten Island, NY
  • NPI 1649255365
  NPD (past)

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750365201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 TODT HILL RD",
            "address_2": "SUITE 204",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144528",
            "telephone_number": "718-273-2626",
            "fax_number": "718-442-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 TODT HILL RD",
            "address_2": "SUITE 204",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144528",
            "telephone_number": "718-273-2626",
            "fax_number": "718-442-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESENTHAL",
        "first_name": "CARL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "129216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan P Wieber, MA CCC SLP
• Asher Wiederkehr, DPM
• Jennifer Wiener
• Jennifer Faith Wiener, LCSW
• Ellie Wiese
• Timothy Wigand
• Linda H Wilcox
• Lauren Nicole Wilen
• Matthew Wilensky, OTA
• Melissa Mbiayon Mbatchou Wilfrid, MD

• Otolaryngology Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Otolaryngology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.