Individual
GREGORY WALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 FRANKLIN AVE, VALLEY STREAM, NY 11580-2145
(516) 256-6000
Mailing address
27 GODFREY AVE, BAYVILLE, NY 11709-2711
(516) 458-6811
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2072246
NY
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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