Provider Demographics
NPI:1356343925
Name:WISHNOW, DONALD ELLIOTT (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ELLIOTT
Last Name:WISHNOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13779 75TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2815
Mailing Address - Country:US
Mailing Address - Phone:718-268-7890
Mailing Address - Fax:
Practice Address - Street 1:948 48TH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2918
Practice Address - Country:US
Practice Address - Phone:718-283-8329
Practice Address - Fax:718-283-6255
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2025-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0869462084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY40K901Medicare ID - Type Unspecified