Individual
ALLEGRA DACOSTA-WALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 E 74TH ST, NEW YORK, NY 10021-3459
(917) 477-9594
Mailing address
11314 72ND RD APT 2P, FOREST HILLS, NY 11375-4610
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
714420
NY
364SG0600X
Gerontology Clinical Nurse Specialist
714420
NY
Other
Enumeration date
09/27/2022
Last updated
09/27/2022
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