Individual
BRODY MICHAEL WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-2500
Mailing address
PO BOX 166, WOODRIDGE, NY 12789-0166
(845) 798-1878
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
327145
NY
Other
Enumeration date
03/21/2019
Last updated
05/30/2024
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