Individual provider · Type 1 NPI

Jennifer Grace Wiley

Specialist · Lake Ronkonkoma, NY

NPI number 1821351602 Active

Practice location

10 Center St
Lake Ronkonkoma, NY 11779-4524

Call (631) 428-3508 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X899067 (NY)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1821351602

Jennifer Grace Wiley's National Provider Identifier is 1821351602, issued on Jun 18, 2012. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Lake Ronkonkoma, NY. The record was last updated on Jun 18, 2012.