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SIDNEY RODOLFO WILSON PA12
NPI 1861439523
Physician Assistant - Medical in Flushing, NY

Active since June 01, 2006
4115 162ND ST, FLUSHING, NY 11358(718) 762-6640 Get Directions Write a Review

NPPES record last updated: May 4, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Sidney Rodolfo Wilson Pa12 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SIDNEY RODOLFO WILSON PA12 (NPI 1861439523) is an individual medical provider in Flushing, New York, licensed in New York (006481) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1861439523
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameSIDNEY RODOLFO WILSONCredential: PA12
Location Address4115 162ND STFlushing, NY 11358-4124
Mailing Address448 E 45th StBrooklyn, NY 11203-4120 · (718) 287-5450
Phone(718) 762-6640
Sole ProprietorYes
Enumeration DateJune 1, 2006
Last NPPES UpdateMay 4, 2010
✔ NPI 1861439523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NY · 006481
4115 162ND ST, Flushing, NY 11358
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sidney Wilson's NPI number?

The NPI number for Sidney Wilson is 1861439523. It was assigned to this individual provider in the NPPES registry on June 1, 2006.

Where is Sidney Wilson located?

Sidney Wilson practices at 4115 162nd St, Flushing, NY 11358. The listed phone number is (718) 762-6640.

What is Sidney Wilson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Sidney Wilson was last updated on May 4, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.