Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ellie Wiese

Individual provider Physician Assistant · NPI 1386332401

Ellie Wiese is a Physician Assistant in Staten Island, New York. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1 Campus Rd
Staten Island, NY 10301-4479
Phone: (718) 390-3100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1386332401
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 26, 2023
Last updated in NPPESApril 26, 2023
Certification dateApril 26, 2023

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