Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dafna Rachel Wild, PA

Individual provider Physician Assistant · NPI 1174750319

Dafna Rachel Wild, PA is a Physician Assistant in Jersey City, New Jersey. Qualified in 2005, 21 years ago. Practices with Clark Dermatology LLC, a 46-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
21
Licensed in
NJ
In the registry since
2009
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

100 Pavonia Ave Ste 409
Jersey City, NJ 07310-2778
Phone: (201) 626-4040
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 25MP00209700 (NJ)

Record details

NPI number1174750319
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJune 15, 2009
Last updated in NPPESJune 15, 2009

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Clark Dermatology Llc — 46 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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