Individual
MS. GERALDINE WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
877 STEWART AVE, SUITE 33, GARDEN CITY, NY 11530-4803
(516) 745-5621
(516) 227-2544
Mailing address
877 STEWART AVE, SUITE 33, GARDEN CITY, NY 11530-4803
(516) 745-5621
(516) 227-2544
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381849-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02941293
—
NY
Enumeration date
02/02/2007
Last updated
05/01/2014
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