AUDREY R WILSON


Address: 1815 Cottman Ave, Philadelphia, PA 19111
Phone: 2157425662

AUDREY R WILSON (NPI# 1437126661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437126661
Entity Type Individual
Full Name AUDREY R WILSON
Other Name AUDREY RADOMSKY
Credential MD
Practice Address 1815 Cottman Ave
Philadelphia
PA 19111
Mailing Address 980 Us Highway 9
South Amboy
NJ 08879
Practice Telephone 2157425662
Practice Fax Number 2157425663
Mailing Telephone 7325539729
Mailing Fax Number 7325539730
Enumeration Date 2006-03-07
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
MD029434L PA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
PA 0009479910015 05

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1124358502 Audrey Y. Wilson Case Manager/Care Coordinator 919 2nd St Ne, Canton, OH 44704-1132 2010-01-06
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Office Location

Street Address 1815 COTTMAN AVE
City PHILADELPHIA
State PA
Zip Code 19111

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164036026 Grace Agency Incorporated Home Health 433 Longshore Ave, Philadelphia, PA 19111 2020-09-08
1124517750 Dana Christine Campetti Physician Assistant 700 Cottman Ave Ste 201, Philadelphia, PA 19111 2018-05-09
1235654286 Dorotea Mutabdzic Surgery Fox Chase Cancer Center, 333 Cottman Ave, Dept of Surgical Oncology, Philadelphia, PA 19111 2017-08-11
1952841041 Personal Care Home C&g Point of Service 6176 Newtown Ave, Philadelphia, PA 19111 2017-03-08
1477006849 Fox Chase Cancer Center Clinic/Center 333 Cottman Ave., Philadelphia, PA 19111 2016-08-02
1578927521 Peter Whooley Student in an Organized Health Care Education/Training Program Temple University/fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111 2016-04-06
1043673783 Matthew Holzerman Physical Therapy Assistant 1148 Tabor Plz, Philadelphia, PA 19111 2016-03-31
1831563329 Aging With Care Inc Home Health 1614 Loney St, Philadelphia, PA 19111 2015-11-20
1043687551 Kenneth Marsaglia II Preventive Medicine 8414 Bridle Road, Philadelphia, PA 19111 2015-09-01
1700220514 Lorraine A Tauriello Counselor 716 Ripley St, Philadelphia, PA 19111 2013-04-23
Find all providers in zip 19111

Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063067635 Jefferson University Radiology Associates, LLC Radiology 3 Crescent Dr Ste 1002, Philadelphia, PA 19112-1016 2019-08-09
1033649975 Dinh-huy Do Nguyen Radiology 5501 Old York Rd Ste 363, Philadelphia, PA 19141-3018 2017-06-13
1467809418 Jeffrey Burgess Radiology 1215 Spruce St Apt 201, Philadelphia, PA 19107-5620 2016-05-19
1649632399 Myron Blumberg Radiology 317 S 22nd St, Philadelphia, PA 19103-6528 2016-03-22
1144633074 Daniel Robert Wahl Radiology 3400 Spruce Street - 1 Silverstein, Department of Radiology / Abdominal Imaging, Philadelphia, PA 19104 2014-06-09
1235564337 Ron Benjamin Radiology 2055 E Fletcher St, Philadelphia, PA 19125 2013-09-08
1831454867 Ryan Michael Bonshock Radiology 4220 Market St Fl 2, Philadelphia, PA 19104-3007 2012-07-05
1730498601 Robert A Perkins Jr. Radiology 132 S 10th St Ste 1099j, Philadelphia, PA 19107-5244 2010-09-27
1457677007 Michael Richard Acord Radiology 3401 Civic Blvd, Division of Radiology, Philadelphia, PA 19104 2010-04-07
1780918375 Mollie Mcginley Radiology 1835 Arch St, Apartment 305, Philadelphia, PA 19103-2712 2009-09-29
Find all providers in PHILADELPHIA

Competitor

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City PHILADELPHIA
Zip Code 19111

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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