Individual
DR. MARK WILLIAM WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 W 58TH ST, 313, NEW YORK, NY 10019-1827
(917) 441-2344
Mailing address
330 W 58TH ST, 313, NEW YORK, NY 10019-1827
(917) 441-2344
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
208200
NY
Other
Enumeration date
07/08/2005
Last updated
12/13/2013
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