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Provider Information for 1255714184


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THOMAS A. WILKIE MHC-LP


Sex: Male

NPI: 1255714184
Last Updated: 2015-07-09
Certification Date:

Details

NameValue
NPI1255714184
Enumeration Date2015-07-09
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 421 27TH AVE
ASTORIA, NY 11102-4175
United States

Phone: 718-777-6375 | Fax:718-728-3207
 
Primary Practice Address 421 27TH AVE
ASTORIA, NY 11102-4175
United States

Phone: 718-777-6375 | Fax:718-728-3207
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthNYP96732