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

Mr. Collis Jeremy Wilson, SPECIALIST

Individual provider Specialist · NPI 1043155542

Mr. Collis Jeremy Wilson, SPECIALIST is a Specialist in Brooklyn, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2026

Practice location Address checks out

1275 E 84th St
Brooklyn, NY 11236-4911
Phone: (347) 873-2161
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 2022342261 (NY)

Record details

NPI number1043155542
Entity typeIndividual (Type 1)
GenderMale
Credentials SPECIALIST
Sole proprietorYes
NPI enumeratedApril 21, 2026
Last updated in NPPESApril 21, 2026
Certification dateApril 21, 2026

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