Individual
MISS GLORIA S WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1663 E 17TH ST, BROOKLYN, NY 11229-1259
(718) 998-0200
(719) 339-4171
Mailing address
1431 WHITE PLAINS RD, BRONX, NY 10462-4103
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
442354-1
NY
Other
Enumeration date
07/15/2010
Last updated
07/15/2010
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