Provider Demographics
NPI:1407904063
Name:WISER-ESTIN, MINDY E (MD)
Entity Type:Individual
Prefix:DR
First Name:MINDY
Middle Name:E
Last Name:WISER-ESTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WHITE RD
Mailing Address - Street 2:STE 105
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1150
Mailing Address - Country:US
Mailing Address - Phone:732-741-3331
Mailing Address - Fax:732-741-5119
Practice Address - Street 1:200 WHITE RD
Practice Address - Street 2:STE 105
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1150
Practice Address - Country:US
Practice Address - Phone:732-741-3331
Practice Address - Fax:732-741-5119
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA68274207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology