Provider Demographics
NPI:1578698742
Name:HEALTHWISE MEDICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:HEALTHWISE MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:EMEKA
Authorized Official - Last Name:ONYEMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-686-5782
Mailing Address - Street 1:401 E 34TH ST
Mailing Address - Street 2:SUITE SOUTH 35D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4914
Mailing Address - Country:US
Mailing Address - Phone:212-686-5782
Mailing Address - Fax:
Practice Address - Street 1:401 E 34TH ST
Practice Address - Street 2:SUITE SOUTH 35D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4914
Practice Address - Country:US
Practice Address - Phone:212-686-5782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190077207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP618936OtherOXFORD
NY178149OtherELDER PLAN
NY110194494OtherUHC RAILROAD
NY2C6442OtherHEALTH NET
NY1530402OtherUNITEDHEALTHCARE
NY433056NAOtherCIGNA
NY31N253OtherEMPIRE
NY3300180OtherGHI
NY085AS2OtherEMPIRE
NY01624244Medicaid
NY085AS3OtherEMPIRE
NY085AS2OtherEMPIRE
NY178149OtherELDER PLAN
NY2C6442OtherHEALTH NET