Individual
BENNETT LEROY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
601 ELMWOOD AVE BOX 626, ROCHESTER, NY 14642-0001
(585) 273-4580
(585) 276-1350
Mailing address
601 ELMWOOD AVE BOX 626, ROCHESTER, NY 14642-0001
(585) 273-4580
(585) 276-1350
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
303347
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0039
—
NY
Enumeration date
05/24/2017
Last updated
07/21/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us