Provider Demographics
NPI:1962401307
Name:WISLER, BARRY ALAN (DPM)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ALAN
Last Name:WISLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1773 KUSER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3703
Mailing Address - Country:US
Mailing Address - Phone:609-585-4433
Mailing Address - Fax:609-585-8288
Practice Address - Street 1:1773 KUSER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3703
Practice Address - Country:US
Practice Address - Phone:609-585-4433
Practice Address - Fax:609-585-8288
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0000MD940213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3387500Medicaid
NJ0563690001Medicare NSC
NJ146324Medicare PIN
NJT77706Medicare UPIN