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NPI Code Detail

MEDICARE: DR. ANGELA WILKOS PSY.D.

MEDICARE: DR. ANGELA WILKOS PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist020529NY
2103TC0700XClinical Psychologist020529NY
3103T00000XPsychologist35SI00571600NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215329735
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA WILKOS PSY.D.
Provider Business Mailing Address
First Line : 20 COMMERCE DR STE 135
Second Line :
City : CRANFORD
State : NJ
Zip : 07016-3614
Country : US
Telephone Number : 848-219-0136
Fax Number :
Provider Business Practice Location Address
First Line : 20 COMMERCE DR STE 135
Second Line :
City : CRANFORD
State : NJ
Zip : 07016-3614
Country : US
Telephone Number : 848-219-0136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2015
Last Update Date : 03/17/2018

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