| Doctor Name: | DR. JAMES J. WISECUP |
| NPI Number: | 1013213362 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.MIN. |
| License Number: | 001142 |
| Business Practice Address: | 53 W Bank Ln Stamford, CT - 069021309 |
| Business Phone Number: | 2036029969 |
| Business Fax Number: | 2036022234 |
| Mailing Address: | 53 W Bank Ln, STAMFORD |
| State: | CT |
| Postal Code: | 069021309 |
| Phone Number: | 2036029969 |
| Fax Number: | 2036022234 |
| NPI Enumeration Date: | 02/03/2011 |
| NPI Last Update Date: | 02/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 001142 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |