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General NPI Number Information
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NPI Number | 1225357007
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Entity Type | Individual
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Provider Name | DAMALI M. WILSON N.P.
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Gender | Female
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 9708 SEAVIEW AVE
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City | BROOKLYN
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State | NY
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Zip | 11236-5516
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Country | US
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Telephone | 718-444-0520
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Fax | 718-444-1898
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Provider Business Mailing Address
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Address Line | 135 MINEOLA BLVD FL 2
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City | MINEOLA
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State | NY
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Zip | 11501-3917
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Country | US
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Telephone | 917-310-3371
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Fax | 516-938-1554
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN1016778
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License Number State | DC
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