| Doctor Name: | DR. CHERYL WISNIEWSKI |
| NPI Number: | 1063673036 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPM |
| License Number: | 25MD00296900 |
| Business Practice Address: | 722 Mantua Pike Suite 8 Woodbury Heights, NJ - 080971141 |
| Business Phone Number: | 8563841333 |
| Business Fax Number: | 8563841297 |
| Mailing Address: | 722 Mantua Pike, Suite 8 WOODBURY HEIGHTS |
| State: | NJ |
| Postal Code: | 080971141 |
| Phone Number: | 8563841333 |
| Fax Number: | 8563841297 |
| NPI Enumeration Date: | 06/22/2008 |
| NPI Last Update Date: | 06/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 25MD00296900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |