Provider Demographics
NPI:1235683871
Name:WISE, ANNE-MARGARET (NP)
Entity type:Individual
Prefix:MS
First Name:ANNE-MARGARET
Middle Name:
Last Name:WISE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:ANNE-MARGARET
Other - Middle Name:
Other - Last Name:MCCAFFERTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1050 PITTSFORD VICTOR RD
Mailing Address - Street 2:BUILDING B
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-3812
Mailing Address - Country:US
Mailing Address - Phone:585-383-4040
Mailing Address - Fax:585-383-4051
Practice Address - Street 1:1050 PITTSFORD VICTOR RD
Practice Address - Street 2:BUILDING B
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-3812
Practice Address - Country:US
Practice Address - Phone:585-383-4040
Practice Address - Fax:585-383-4051
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307725363LA2100X
NYF307725363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care