Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 255893 | NY |
Y | 2086S0127X | Trauma Surgeon | 255893 | NY |
NPI | 1659406593 |
---|---|
Provider Name | Dr. Abralena De Jesus Wilson |
First Address | Bronx, NY 10451-5504 |
Second Address | Bronx, NY 10451-5504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 22/07/2019 |