Most Relevant Information
Provider Data
| NPI Number: | 1003558966 |
| Provider Name: | JOSHUA ALLEN WILSON MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/11/2022 |
| Last Updated: | 04/11/2022 |
Provider Practice Location
121 DEKALB AVE
BROOKLYN
NY
112015425
Practice Location Phone/Fax
| Phone: | 7182508000 |
| Fax: |
Provider Mailing Location
121 DEKALB AVE
BROOKLYN
NY
112015425
Provider Mailing Phone/Fax
| Phone: | 7182508000 |
| Fax: |