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

Kevin Walter Wieczenski

Individual provider Family Nurse Practitioner · NPI 1811674278

Kevin Walter Wieczenski is a Nurse Practitioner in Fonda, New York. Qualified in 2023, 3 years ago. Practices with Nathan Littauer Hospital Association, a 94-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2023

Practice location Address checks out

46 E Main St
Fonda, NY 12068-4821
Phone: (518) 773-5308
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 352281 (NY)

Record details

NPI number1811674278
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 28, 2023
Last updated in NPPESJune 28, 2023
Certification dateJune 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Nathan Littauer Hospital Association — 94 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fonda