Organization
WILDWOOD PROGRAMS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY R. MILFORD (CHIEF FINANCIAL OFFICER)
(518) 356-6410
Entity
Organization
Contact information
Practice address
1190 TROY SCHENECTADY RD, LATHAM, NY 12110-1026
(518) 783-3421
(518) 785-9670
Mailing address
2995B CURRY ROAD EXTENSION, SCHENECTADY, NY 12303
(518) 356-6410
(518) 356-3603
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
013600
NY
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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