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Organization
WISE MIND LIVING PSYCHIATRY PC
Active
Organization
WISE MIND LIVING PSYCHIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK WILLIAM WILSON MD (OWNER)
(212) 579-3639
Entity
Organization
Contact information
Practice address
330 W 58TH ST STE 313, NEW YORK, NY 10019-1821
(212) 579-3639
(917) 725-8234
Mailing address
330 W 58TH ST STE 313, NEW YORK, NY 10019-1821
(212) 579-3639
(917) 725-8234
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5862037
WE DO NOT ACCEPT INSURANCE
NY
Enumeration date
10/27/2020
Last updated
10/27/2020
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