Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Anderson Ricardo Wilson, PA

Individual provider Physician Assistant · NPI 1063626000

Mr. Anderson Ricardo Wilson, PA is a Physician Assistant in Brooklyn, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2007
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

611 E 78th St
Brooklyn, NY 11236-3307
Phone: (646) 344-9134
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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 002708-1 (NY)

Record details

NPI number1063626000
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedMay 9, 2007
Last updated in NPPESJuly 8, 2007

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