Individual
BRANDI EMILY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 7TH AVE, NEW YORK, NY 10011-6629
(718) 810-7430
Mailing address
14814 BROOKVILLE BLVD, ROSEDALE, NY 11422-3273
(718) 810-7430
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
709156
NY
Other
Enumeration date
06/04/2025
Last updated
06/04/2025
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