Individual
ANDREA MARGARET WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8221 ROYAL SCARLET DR, BALDWINSVILLE, NY 13027-8942
(315) 313-3458
Mailing address
8221 ROYAL SCARLET DR, BALDWINSVILLE, NY 13027-8942
(315) 313-3458
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
751264-1
NY
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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