MEDICARE: AUDREY R WILSON MD

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
1	2085R0202X	Diagnostic Radiology Physician	MD029434L	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1437126661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY R WILSON MD

Provider Business Mailing Address
First Line	:	980 US HIGHWAY 9
Second Line	:
City	:	SOUTH AMBOY
State	:	NJ
Zip	:	08879
Country	:	US
Telephone Number	:	732-553-9729
Fax Number	:	732-553-9730

Provider Business Practice Location Address
First Line	:	1815 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111
Country	:	US
Telephone Number	:	215-742-5662
Fax Number	:	215-742-5663

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1477400638 — ANDREW GROSSMAN LSW
Practice Location Address:

1919 COTTMAN AVE
PHILADELPHIA, PA
19111-3816

Practice Phone: 267-350-4727
Practice Fax: 215-745-6511

1154278323 — REBECCA PHILIPPE
Practice Location Address:

1919 COTTMAN AVE
PHILADELPHIA, PA
19111-3816

Practice Phone: 267-350-4802
Practice Fax: 215-745-6511

1851620496 — KND DEVELOPMENT 59 LLC
Practice Location Address:

6129 PALMETTO ST
PHILADELPHIA, PA
19111-5729

Practice Phone: 215-722-8555
Practice Fax: 502-596-4150

1316262363 — DR. MANUJ AGARWAL MD
Practice Location Address:

333 COTTMAN AVENUE
PHILADELPHIA, PA
19111-2434

Practice Phone: 215-728-2581
Practice Fax: 215-214-4038

1497603641 — MS. ERIN LEIGH CARTER
Practice Location Address:

1733 BORBECK AVE FL 1
PHILADELPHIA, PA
19111-3514

Practice Phone: 347-993-5132
Practice Fax:

1063368108 — MILAN HOME CARE SERVICES
Practice Location Address:

7255 RISING SUN AVE
PHILADELPHIA, PA
19111-3926

Practice Phone: 267-307-3838
Practice Fax:

1033065040 — ROYALTYKARE LLC
Practice Location Address:

7210 OXFORD AVE APT 2N
PHILADELPHIA, PA
19111-4058

Practice Phone: 215-907-7292
Practice Fax:

Directions to “ AUDREY R WILSON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.