Individual
MRS. MARJORIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
56 ELIZABETH STREET, STATEN ISLAND, NY 10310
(646) 229-0941
Mailing address
56 ELIZABETH ST, STATEN ISLAND, NY 10310-1934
(646) 229-0941
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F307602
NY
Other
Enumeration date
06/27/2017
Last updated
07/21/2022
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