NPI 1811674278

Kevin Walter Wieczenski

Practitioner Family Nurse Practitioner Fonda, NY

Practice location

Address: 46 E Main St, Fonda, NY 12068-4821
Phone: (518) 773-5308
Mailing address: 99 E State St, Gloversville, NY 12078-1203

Registered specialties

Family Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LF0000X Licence 352281 (NY)

Other Nurse Practitioner providers in New York →

Registry record

NPI: 1811674278
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Jun 2023
Record last updated: 28 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.