Individual
MICHAEL WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
LINDENHURST MIDDLE SCHOOL, 350 SOUTH WELLWOOD AVE, LINDENHURST, NY 11757
(631) 867-3510
Mailing address
25 LLOYD LN, NESCONSET, NY 11767-2208
(917) 359-1933
Taxonomy
Speciality
Code
Description
License number
State
364SS0200X
School Clinical Nurse Specialist
Primary
447785
NY
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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