Provider Demographics
NPI:1316735814
Name:WISER, JULIAN REED (EMT, CPHT, MHFA)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:REED
Last Name:WISER
Suffix:
Gender:M
Credentials:EMT, CPHT, MHFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E 44TH ST APT 19H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4073
Mailing Address - Country:US
Mailing Address - Phone:813-909-5136
Mailing Address - Fax:
Practice Address - Street 1:221 W 77TH ST APT 11W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6796
Practice Address - Country:US
Practice Address - Phone:212-401-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30297918183700000X
NY518910146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No183700000XPharmacy Service ProvidersPharmacy Technician