Individual
MR. THOMAS L WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
255 GORDON ST, STATEN ISLAND, NY 10304-1943
(888) 554-3810
(206) 426-0930
Mailing address
30 DANIEL LOW TER APT 4K, STATEN ISLAND, NY 10301-1740
(888) 554-3810
(206) 426-0930
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
579666
NY
Other
Enumeration date
11/20/2012
Last updated
11/21/2012
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