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1316210131
DANIEL MARK WILSON
WEST ISLIP, NY
NPI
1316210131
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: NY 015362-1)
Enumeration Date
2012-02-10
Last Update Date
2012-02-22
Business Address
Mr. DANIEL MARK WILSON RPA-C
1000 MONTAUK HWY
WEST ISLIP, NY 11795-4927
Phone number: 631-376-4444
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Mailing Address
Mr. DANIEL MARK WILSON RPA-C
20 MALLARD RD
LEVITTOWN, NY 11756-4204
Phone number:
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