Individual
NIAMEY SUSANNAH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
114 WOODLAND ST, COMPREHENSIVE WOMEN'S HEALTH CENTER-BREAST CENTER, HARTFORD, CT 06105-1208
(860) 714-6318
(860) 714-9990
Mailing address
455 LEWIS AVE, STE 203, MERIDEN, CT 06451-2121
(860) 714-6318
(860) 714-9990
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
53269
CT
208600000X
Surgery Physician
MT188433
PA
2086X0206X
Surgical Oncology Physician
53269
CT
Other
Enumeration date
01/05/2007
Last updated
12/05/2018
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