Provider Demographics
NPI:1457713182
Name:WETCHER, CARA (MD)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:WETCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:
Other - Last Name:STASZEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:376 E MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8441
Mailing Address - Country:US
Mailing Address - Phone:631-396-7000
Mailing Address - Fax:
Practice Address - Street 1:376 E MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8441
Practice Address - Country:US
Practice Address - Phone:631-396-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302737207VX0000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics