Provider Demographics
NPI:1861410185
Name:WILNER, PHILIP JONATHAN (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:JONATHAN
Last Name:WILNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:525 E 68TH ST
Mailing Address - Street 2:BOX #140
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-3705
Mailing Address - Fax:212-746-5943
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:BOX #140
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4870
Practice Address - Country:US
Practice Address - Phone:212-746-3705
Practice Address - Fax:212-746-5943
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1589532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA60489Medicare UPIN