Jack Wilson

NPI 1396806519 - Pharmacist - 183500000X

NPI Details
NPI 1396806519
Gender Male
Enumeration Date 12/12/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
8823 AVENUE L
BROOKLYN NY, 11236-4781, US
Phone (718) 251-4005
Fax (718) 251-4006
Business Location
8823 AVENUE L
BROOKLYN NY, 11236-4781, US
Phone (718) 251-4005
Fax (718) 251-4006
Toxanomy
Taxonomy Code 183500000X
License State New York
License Number 014795
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According to our database, Mr. Jack Wilson NPI is 1396806519, taxonomy code is 183500000X and license number is 014795, license state is located at New York. Jack Wilson physically located at 8823 Avenue L, Brooklyn NY, 11236-4781. NPI Number Jack Wilson has the Individual type.

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1396806519 NPI number is provided on an as is basis without warranty of any kind. 1396806519 is maintained by the National Plan & Provider Enumeration System. The contents of Jack Wilson are for informational purposes only.