Maryam Wiseman, P.T.

Primary specialty

SpecialistTaxonomy code 174400000X

License

0158541 Issued in NY

Practice address

21 Cary Rd
Great Neck, NY 11021-1517

Phone

(516) 946-8333

NPI assigned

Jul 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1801096524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CARY RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211517",
            "telephone_number": "516-946-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CARY RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211517",
            "telephone_number": "516-946-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "MARYAM",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "0158541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1265537005",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02284724",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regina Winocur, M.A.,R.D.,C.D.E
• Winston B Paley MD PC
• Winthrop Community Medical Affiliates, PC
• Wise Bites Nutrition PLLC
• Eshagh Wiseman, MD
• Jeffrey M. Wolf, M.D.
• Sonia Marie Wolf, OTR/L
• Elizabeth Wolfe-Medina, O.T.
• Nancy Sue Wolfin, M.D.
• Gary Norman Wolk, M.D.

• Specialist in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.