Individual
DANIELLE WALTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
712 MAIN ST, ISLIP, NY 11751-3620
(631) 666-3939
Mailing address
35 KAHN LN, WEST BABYLON, NY 11704-7226
(631) 786-0817
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F352925-01
NY
Other
Enumeration date
11/20/2023
Last updated
06/06/2025
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