Provider Demographics
NPI:1467446070
Name:WILENTZ, JAMES R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:WILENTZ
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Gender:M
Credentials:MD
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Mailing Address - Street 1:10 UNION SQ E
Mailing Address - Street 2:STE 5M1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3314
Mailing Address - Country:US
Mailing Address - Phone:212-253-6800
Mailing Address - Fax:212-253-6100
Practice Address - Street 1:10 UNION SQ. E.
Practice Address - Street 2:STE 5M1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3314
Practice Address - Country:US
Practice Address - Phone:212-253-6800
Practice Address - Fax:212-253-6100
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2015-07-01
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Provider Licenses
StateLicense IDTaxonomies
NY165980207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00996218Medicaid
NY00996218Medicaid