Individual
MR. CHRISTOPHER JESSE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
79 MIDDLEVILLE RD BLDG 11, NORTHPORT, NY 11768-2200
(631) 261-4400
Mailing address
31 CAYUGA AVE, EAST NORTHPORT, NY 11731-1044
(318) 542-0680
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
814303
NY
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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