NAOMI NICOLE WILDER PA-C NPI 1982899027

NPI Information

NPI: 1982899027
Provider Name: NAOMI NICOLE WILDER, PA-C
Classification: Physician Assistant - 363AS0400X
Specialization: Surgical
Entity Type: Individual
PECOS Registration: Yes
Address: 1205 TROY SCHENECTADY RD STE 101
LATHAM, NY
ZIP 12110
Phone: (518) 348-3176

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NPI Details

Naomi Nicole Wilder, PA-C is a surgical physician assistant in Latham, NY. Naomi Nicole Wilder, PA-C NPI is 1982899027. 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:

1205 TROY SCHENECTADY RD STE 101
LATHAM, NY
ZIP 12110-074
Phone: (518) 348-3176

The NPI 1982899027 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/12/2007 and was last updated on 10/24/2019.

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
1	363AS0400X	Physician Assistant	Surgical	012007	NEW YORK	Yes

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
1	01529253	MEDICAID	NEW 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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