Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 244715 | NY |
N | 208000000X | Pediatrician | 50711 | CO |
N | 2080P0204X | Pediatric Emergency Doctor | 244715 | NY |
NPI | 1194731737 |
---|---|
Provider Name | Dr. Karen Wilson |
First Address | New York, NY 10029-6504 |
Second Address | New York, NY 10029-6504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 30/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03505766 | (05) | CO |