Individual
SANDRA BOATENG-WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2015 GRAND CONCOURSE, BRONX, NY 10453
(718) 299-7294
(718) 294-6797
Mailing address
3198 GRAND CONCOURSE, BRONX, NY 10458-1000
(718) 618-0401
(347) 429-8467
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
592824
NY
363LF0000X
Family Nurse Practitioner
338663
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F404138
NY
Other
Enumeration date
11/04/2008
Last updated
04/18/2024
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