Individual
ASIA WILSON-MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
418 BROADWAY STE 4286, ALBANY, NY 12207-2922
(929) 746-6119
Mailing address
418 BROADWAY STE 4286, ALBANY, NY 12207-2922
(929) 746-6119
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
608193
NY
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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