Provider Demographics
NPI:1174589139
Name:WISCOVITCH, ADANETTE (MD)
Entity type:Individual
Prefix:DR
First Name:ADANETTE
Middle Name:
Last Name:WISCOVITCH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:MONTEHEIDRA TOWN CTR
Mailing Address - Street 2:53 FALCON ST.
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7007
Mailing Address - Country:US
Mailing Address - Phone:787-731-1346
Mailing Address - Fax:787-771-7996
Practice Address - Street 1:PONCE DE LEON AVE AUXILIO MUTUO
Practice Address - Street 2:PDA 37 1/2
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00923
Practice Address - Country:US
Practice Address - Phone:787-758-2000
Practice Address - Fax:787-771-7996
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR96702080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology