Dewi Wijaya

NPI #1215308820 in Roslyn, New York

Provider Information

NPI Number: 1215308820
Entity Type: Individual
Name: Dewi Wijaya
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Oct 8, 2015
Last Updated: Oct 8, 2015

Practice Location

Address: 33 URSULA DR
City: Roslyn
State: New York
ZIP Code: 11576-3020
Phone: (646) 338-7130

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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