Provider Demographics
NPI:1447424221
Name:WENGER, MARIA LIZA (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:LIZA
Last Name:WENGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:LIZA
Other - Last Name:SARMIENTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1305 YORK AVE FL 8
Mailing Address - Street 2:DIVISION OF CARDIOLOGY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5663
Mailing Address - Country:US
Mailing Address - Phone:646-962-5558
Mailing Address - Fax:646-962-0050
Practice Address - Street 1:1305 YORK AVE FL 8
Practice Address - Street 2:DIVISION OF CARDIOLOGY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5663
Practice Address - Country:US
Practice Address - Phone:646-962-5558
Practice Address - Fax:646-962-0050
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301694363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health