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NPI Code Detail

MEDICARE: MR. BRIAN RICHARD WILKOW PHYSICIAN ASSISTANT

MEDICARE: MR. BRIAN RICHARD WILKOW PHYSICIAN ASSISTANT
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
1363A00000XPhysician Assistant003308NY

General Provider Information

NPI Number : 1871520510
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN RICHARD WILKOW PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : 506 6TH ST
Second Line : MEDICAL AFFAIRS OFFICE
City : BROOKLYN
State : NY
Zip : 11215-3609
Country : US
Telephone Number : 718-780-5942
Fax Number : 718-780-3287
Provider Business Practice Location Address
First Line : 506 6TH ST
Second Line : MEDICAL AFFAIRS OFFICE
City : BROOKLYN
State : NY
Zip : 11215-3609
Country : US
Telephone Number : 718-780-5942
Fax Number : 718-780-3287
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 01/25/2026

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