Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 264096 | NY |
N | 2086S0105X | Surgery of the Hand | 264096 | NY |
NPI | 1013175942 |
---|---|
Provider Name | Dr. Adam N Wilson |
First Address | Garden City, NY 11530-1886 |
Second Address | Garden City, NY 11530-1886 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2008 |
Last Update Date | 02/04/2021 |