A.D.J. Wilson LLC

Primary specialty

Trauma Surgery PhysicianTaxonomy code 2086S0127X

Legal business name

A.D.J. WILSON LLC

Practice address

132 Myrtle Ave Apt 21
Fort Lee, NJ 07024-7925

Phone

(215) 370-2606

NPI assigned

Sep 7, 2024

Last updated

Sep 20, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Abralena De Jesus Wilson, DONPI 1659406593

Title

Owner

Phone

(215) 370-2606

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Abralena De Jesus Wilson, D.O

  • Trauma Surgery Physician
  • West Islip, NY
  • NPI 1659406593
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1962237933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 MYRTLE AVE APT 21",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247925",
            "telephone_number": "215-370-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 MYRTLE AVE APT 21",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247925",
            "telephone_number": "215-370-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A.D.J. WILSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-07",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ABRALENA",
        "authorized_official_middle_name": "DE JESUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-370-2606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Trauma Surgery Physician in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Trauma Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.