Individual
DR. AMANDA MOBERG WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21 W 86TH ST, SUITE 209, NEW YORK, NY 10024-3671
(917) 715-2886
Mailing address
1160 5TH AVE, # 407, NEW YORK, NY 10029-6928
(917) 715-2886
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
DO NOT HAVE ONE-PGY1
NY
Other
Enumeration date
05/21/2008
Last updated
08/15/2012
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