Individual provider · Type 1 NPI
Kevin Michael Wise Jr., AGPCNP
Primary Care Nurse Practitioner · New York, NY
NPI number
1669300489
Active
Practice location
550 1st Ave
New York, NY 10016-6402
Mailing address
97 Boylan St
Staten Island, NY 10312-1421
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | 312573 (NY) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1669300489
Kevin Michael Wise Jr., AGPCNP's National Provider Identifier is 1669300489, issued on May 12, 2026. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in New York, NY. The record was last updated on May 12, 2026.