Individual
DR. JEROME WILDES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
9116 158TH AVE, HOWARD BEACH, NY 11414-3126
(718) 835-3454
(516) 239-3743
Mailing address
222 BROADWAY, LAWRENCE, NY 11559-1502
(516) 371-6745
(516) 239-3743
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
081878
NY
Other
Enumeration date
09/07/2005
Last updated
11/05/2021
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