Healthcare Provider Details

I. General information

NPI: 1992238836
Provider Name (Legal Business Name): WILSON MAWUTOR ALOBUIA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 1ST AVE # 15W19F
NEW YORK NY
10016-9196
US

IV. Provider business mailing address

462 1ST AVE # 15W19F
NEW YORK NY
10016-9196
US

V. Phone/Fax

Practice location:
  • Phone: 212-562-6522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number346555
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: