Wilde, Geraldine

Wilde, Geraldine is an sole proprietor health care provider with primary practice located at 877 Stewart Ave Suite 33, Garden City NY 11530-4803. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Wilde, Geraldine can be contacted via phone (516) 745-5621.

Contact Information

Primary practice address
877 Stewart Ave Suite 33 Garden City NY 11530-4803
Fax: (516) 227-2544
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X F381849-1 New York

Profile Details

NPI number 1841338522
LBN Legal business name Wilde, Geraldine
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 2nd, 2007
Last updated May 1st, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841338522 NPPES
New York MEDICAID 02941293

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