Provider Demographics
NPI:1720145709
Name:WIENER & PAGANO, P.A.
Entity Type:Organization
Organization Name:WIENER & PAGANO, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WIENER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-368-1717
Mailing Address - Street 1:299 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-5316
Mailing Address - Country:US
Mailing Address - Phone:201-368-1717
Mailing Address - Fax:201-368-9619
Practice Address - Street 1:299 MARKET ST
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5316
Practice Address - Country:US
Practice Address - Phone:201-368-1717
Practice Address - Fax:201-368-9619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56557Medicare UPIN
NJF09096Medicare UPIN