Individual
HALEY RUTH WILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
785 MAMARONECK AVE, WHITE PLAINS, NY 10605-2523
(914) 597-2500
Mailing address
49 WEDGEWOOD DR, GOSHEN, NY 10924-2530
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004936
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004936
NYSEDOP
NY
01
—
2000058250
BOC
—
Enumeration date
10/14/2024
Last updated
01/07/2026
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