Individual
DR. ANDRE WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(877) 426-5637
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(877) 426-5637
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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