Provider Demographics
NPI:1811916521
Name:WISSLER, RICHARD N (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:N
Last Name:WISSLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 604
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-5982
Mailing Address - Fax:585-756-0169
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 604
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-5982
Practice Address - Fax:585-756-0169
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192368207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE58315OtherUPIN
NYG0189393590OtherBLUE CHOICE GROUP
NY00040104401OtherUNIVERA
NY2222OtherBLUE SHIELD GROUP
NY192368-9OtherWORKER'S COMP
NY5193329OtherAETNA
NYMDA525OtherPREFERRED CARE
NYP00120633OtherRAILROAD MEDICARE
NYP010192368OtherBLUE CHOICE