# STEPHEN J WILSON, MD, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891771853
- **Authorized official:** DR. STEPHEN JAY WILSON MD (PRESIDENT)
- **Authorized official phone:** (516) 489-3340

## Contact information

- **Practice address:** 954 MADISON PL, MERRICK, NY 11566-1208
- **Practice address phone:** (516) 489-3340
- **Practice address fax:** (516) 505-2666
- **Mailing address:** 954 MADISON PL, MERRICK, NY 11566-1208
- **Mailing address phone:** (516) 489-3340
- **Mailing address fax:** (516) 505-2666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VM0101X | Maternal & Fetal Medicine Physician | 121280 | NY | Yes |

## Other

- **Enumeration date:** 12/21/2005
- **Last updated:** 08/22/2020