Individual
DR. STEPHEN JAY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
954 MADISON PL, MERRICK, NY 11566-1208
(516) 241-3770
Mailing address
954 MADISON PL, MERRICK, NY 11566-1208
(516) 241-3770
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
121280
NY
Other
Enumeration date
12/03/2014
Last updated
12/03/2014
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