Healthcare Provider Details

I. General information

NPI: 1689390452
Provider Name (Legal Business Name): DR. CAMERON WILKINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 LENOX AVE
NEW YORK NY
10037-1802
US

IV. Provider business mailing address

14 STANZIN CT
MORGANVILLE NJ
07751-2103
US

V. Phone/Fax

Practice location:
  • Phone: 212-939-1000
  • Fax:
Mailing address:
  • Phone: 869-662-3221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number200859
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: