Individual
DR. JENNIFER M WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 JORDAN RD, SUITE 104, TROY, NY 12180-8309
(518) 274-0024
(518) 274-9487
Mailing address
711 TROY SCHENECTADY RD, SUITE 203, LATHAM, NY 12110-2442
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
196142
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0196142
—
NY
Enumeration date
08/09/2005
Last updated
01/05/2017
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