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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. MARK PAUL WILSON, CRPA PROVISIONAL

Active Sole Proprietor

MR. MARK PAUL WILSON, CRPA PROVISIONAL is a Peer Specialist healthcare provider located in E PATCHOGUE, New York. NPI 1770397853 is currently active in the NPPES registry. Verify at CMS.

Peer Specialist · E PATCHOGUE, NY

Registration Details

NPI Number
1770397853
Provider Type
Individual
Gender
Male
NPI Issued
Feb 6, 2025 (1.5282234905137 yrs)
Last Updated
Feb 21, 2025
Sole Proprietor
Yes

Practice Information

Address
98 PINE NECK AVE
E PATCHOGUE, NY, 117725730
Browse NY providers · Browse ZIP 11772
Phone
6319012767
Primary Specialty
Peer Specialist
175T00000X
Additional Specialty
Peer Specialist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.