MS. THERESA CECELIA WILSON PNP NPI 1447481502

NPI Information

  • NPI: 1447481502
  • Provider Name: MS. THERESA CECELIA WILSON, PNP
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: 210 W 139TH ST
    C/O EDWARD NICHOLS MD
    NEW YORK, NY
    ZIP 10030
  • Phone: (212) 234-2121

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NPI Details

MS. Theresa Cecelia Wilson, PNP is a pediatrics nurse practitioner in New York, NY. MS. Theresa Cecelia Wilson, PNP NPI is 1447481502. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

210 W 139TH ST
C/O EDWARD NICHOLS MD
NEW YORK, NY
ZIP 10030-109
Phone: (212) 234-2121
Fax: (212) 234-1759

The enumeration date for this NPI number is 8/6/2009 and was last updated on 8/6/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatrics380137NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
102146716MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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