Individual
EILEEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
139 RONKONKOMA AVE, LAKE RONKONKOMA, NY 11779-3339
(631) 981-4477
(631) 981-5225
Mailing address
139 RONKONKOMA AVE, LAKE RONKONKOMA, NY 11779-3339
(631) 981-4477
(631) 981-5225
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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