Individual
DR. MARK C. WILNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
942 5TH AVE, NEW YORK, NY 10021-2656
(212) 535-2221
(212) 249-5463
Mailing address
20 WATERSIDE PLZ, APT. 32 J, NEW YORK, NY 10010-2612
(212) 685-5282
(212) 685-5945
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
152261
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00960650
—
NY
01
—
152261
LICENCE NUMBER
NY
01
—
69D101
PROVIDER NUMBER
NY
Enumeration date
05/10/2006
Last updated
03/07/2023
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