| Mrs Diana Gail Wische, CRNA | |
|
1 Bay Ave, Montclair, NJ 07042-4837 | |
| (973) 429-6219 | |
| (845) 547-0740 |
| Full Name | Mrs Diana Gail Wische |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1 Bay Ave, Montclair, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992976047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 26NJ00226600 (New Jersey) | Primary |
| Entity Name | Summit Medical Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942254347 PECOS PAC ID: 5395642276 Enrollment ID: O20031218000011 |
| Entity Name | Parkway Anesthesia Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518319755 PECOS PAC ID: 2567758931 Enrollment ID: O20160912000258 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Diana Gail Wische, CRNA 100 Route 59, Suite 105, Suffern, NY 10901-4927 Ph: (845) 357-5775 | Mrs Diana Gail Wische, CRNA 1 Bay Ave, Montclair, NJ 07042-4837 Ph: (973) 429-6219 |
Mr. Timothy L. Murry, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Bay Ave, Montclair, NJ 07042 Phone: 973-429-6250 | |
Ljiljana Kovacevic, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 120 Chestnut St, Montclair, NJ 07042 Phone: 973-842-0464 Fax: 973-972-2357 | |
Erin Ferber, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Bay Avenue, Mountainside Hospital, Montclair, NJ 07042 Phone: 973-429-6000 Fax: 845-357-5777 | |
Marci Viola, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Bay Ave, Anesthesia Office, Montclair, NJ 07042 Phone: 973-429-6219 Fax: 845-547-0740 | |
Dr. Patrick Kelly Russell, DNAP, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1 Bay Ave, Montclair, NJ 07042 Phone: 973-429-6000 | |
Jessica Sanchez, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1 Bay Ave, Montclair, NJ 07042 Phone: 973-429-6000 |