SIDNEY RODOLFO WILSON (NPI# 1861439523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861439523 |
| Entity Type | Individual |
| Full Name | SIDNEY RODOLFO WILSON |
| Credential | PA12 |
| Practice Address |
4115 162nd St Flushing NY 11358-4124 |
| Mailing Address |
448 E 45th St Brooklyn NY 11203-4120 |
| Practice Telephone | 7187626640 |
| Mailing Telephone | 7182875450 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2010-05-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
006481 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235696675 | Sidney Edward Wilson | Driver | 23170 Meadow St, Capron, VA 23829-2562 | 2019-02-21 |
| 1093859563 | Sidney Maurice Wilson | Optometrist | 6745 S Siwell Rd, Suite 106, Byram, MS 39272-8700 | 2007-02-17 |
| Street Address |
4115 162ND ST |
| City | FLUSHING |
| State | NY |
| Zip Code | 11358-4124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508485269 | Jeong Seo | Acupuncturist | 163-26 Northern Blvd, Flushing, Flushing, NY 11358 | 2020-04-13 |
| 1447886510 | Leemaster Corp | Durable Medical Equipment & Medical Supplies | 163-15 Northern Blvd., Unit 2, Flushing, NY 11358 | 2020-03-20 |
| 1912541517 | Myeong R. Choi Acupuncture P.C. | Acupuncturist | 164-10 Crocheron Avenue, Flushing, NY 11358 | 2019-11-06 |
| 1417512203 | Jaekwan Lee | Physical Therapist | 4362 162nd Street, 2nd Floor, Flushing, NY 11358 | 2019-05-07 |
| 1841786324 | Sunshine Rehab Pt PC | Physical Therapist | 19840 32nd Ave Apt B2, Flushing, NY 11358 | 2018-07-08 |
| 1720575756 | Function Integrate Physical Therapy, P.C. | Clinic/Center | 42-10 164th Street, Flushing, NY 11358 | 2018-04-16 |
| 1275055402 | Alexandra Sara Miller | Registered Nurse | 43-43 166th Street, Flushing, NY 11358 | 2017-07-10 |
| 1245750520 | Seongrak Kang | Physical Therapist | 42-12 164th St 1fl, Flushing, NY 11358 | 2017-06-27 |
| 1306366851 | Margaret O'neill | Registered Nurse | 17209 Crocheron Ave C4, Flushing, NY 11358 | 2017-06-26 |
| 1063957280 | Joel Choi | Specialist/Technologist | 3636 166th St, 2nd Fl, Flushing, NY 11358 | 2016-12-24 |
| Find all providers in zip 11358 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023638509 | Kristina Rajic | Physician Assistant | 7237 66th Dr, Flushing, NY 11379-2111 | 2020-04-24 |
| 1932559895 | Victoria Ciano | Physician Assistant | 2736 167th St, Flushing, NY 11358-1126 | 2016-06-21 |
| 1932506094 | Michelle Li | Physician Assistant | 132-59 41st Rd, Ste Cb, Flushing, NY 11355 | 2014-12-04 |
| 1184020315 | Wai Loon Bong | Physician Assistant | 13811 63rd Ave, Flushing, NY 11367-1105 | 2014-11-17 |
| 1841693694 | Katie Jiajia Li | Physician Assistant | 6123 136th St Fl 1, Flushing, NY 11367-1038 | 2014-10-07 |
| 1346515780 | Tae Y Kang | Physician Assistant | 3834 Parsons Blvd # 1a, Flushing, NY 11354-5843 | 2012-03-19 |
| 1881978955 | Joanne Rong | Physician Assistant | 13252 41st Ave, Flushing, NY 11355-5883 | 2011-10-06 |
| 1275833824 | Maryium Riaz | Physician Assistant | 5733 157 St, Flushing, NY 11355 | 2010-10-29 |
| 1225227630 | Hui Ren | Physician Assistant | 13252 41st Ave # M1, Flushing, NY 11355-5845 | 2007-10-22 |
| 1669015053 | Timothy Chan | Physician Assistant | 5645 Main St, Flushing, NY 11355-5045 | 2019-10-18 |
| Find all providers in FLUSHING | ||||
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| 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.