Individual
WADSON FILS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
82-70 164TH STREET, JAMAICA, NY 11432
(718) 880-3070
Mailing address
11 PARK PL, VALLEY STREAM, NY 11580-3000
(718) 926-9354
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
23014276
NY
Other
Enumeration date
10/04/2010
Last updated
10/04/2010
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