Individual
EMANI I WILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-3370
(845) 333-3372
Mailing address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-3370
(845) 333-3372
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
655839
NY
363L00000X
Nurse Practitioner
339952
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
655839
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04554445
—
NY
Enumeration date
06/18/2015
Last updated
11/27/2023
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