Most Relevant Information
Provider Data
| NPI Number: | 1003073545 |
| Provider Name: | AMANDA MOBERG WILSON MD |
| Entity Type: | Individual |
| Taxonomy Code: | 2084P0800X |
| Specialty: | Psychiatry & Neurology |
| License Number: | DO NOT HAVE ONE-PGY1 |
Most Important Dates
| Enumeration Date: | 05/21/2008 |
| Last Updated: | 08/15/2012 |
Provider Practice Location
21 W 86TH ST
SUITE 209
NEW YORK
NY
100243671
Practice Location Phone/Fax
| Phone: | 9177152886 |
| Fax: |
Provider Mailing Location
1160 5TH AVE
# 407
NEW YORK
NY
100296928
Provider Mailing Phone/Fax
| Phone: | 9177152886 |
| Fax: |
Suggested EMR
Psychiatry EMR