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Organization

CHARLES BRUCE WALSH, M.D. LLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ELLEN CARROLL-MCLANE (OFFICE MANAGER)
(914) 636-3373
Entity
Organization

Contact information

Practice address
140 LOCKWOOD AVE, SUITE 103, NEW ROCHELLE, NY 10801-4915
(914) 636-3373
(914) 636-8726
Mailing address
140 LOCKWOOD AVE, SUITE 103, NEW ROCHELLE, NY 10801-4915
(914) 636-3373
(914) 636-8726

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
145593-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01019314
NY
01
0722H1
BCBS HOSPITAL
01
0722H2
BCBS OFFICE
NY
01
0D2758
HEALTHNET
NY
01
1447296
PHCS
NY
01
20041170
RAIL ROAD MEDICARE
01
217377P
HIP
NY
01
2473422002
CIGNA
NY
01
280733P
HIP
NY
01
413191
UNITED HEALTHCARE
01
4653869
AETNA
NY
01
MAGNACARE
11303
NY
01
WS807
OXFORD
NY
Enumeration date
10/02/2007
Last updated
04/20/2008
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