Individual
ANGELA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1725 W 12TH ST, BROOKLYN, NY 11223-1145
(646) 844-0409
(646) 838-4447
Mailing address
770 ROCKWELL LN, DES PLAINES, IL 60016-6218
(347) 707-3959
(877) 599-1211
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
614251
NY
Other
Enumeration date
10/27/2025
Last updated
10/27/2025
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