Provider Demographics
NPI:1801886148
Name:WIENER, CRAIG BENNETT (MD, FACOG)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:BENNETT
Last Name:WIENER
Suffix:
Gender:M
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SEARS DR STE 104
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3525
Mailing Address - Country:US
Mailing Address - Phone:201-262-0075
Mailing Address - Fax:201-262-9440
Practice Address - Street 1:2 SEARS DR STE 104
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3525
Practice Address - Country:US
Practice Address - Phone:201-262-0075
Practice Address - Fax:201-262-9440
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05339700207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology