Individual
STANFORD LEE WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
SOUTH BROOKHAVEN HEALTH CENTER, 365 EAST MAIN ST, PATCHOGUE, NY 11772
(631) 854-1307
(631) 854-1310
Mailing address
1869 BRENTWOOD RD, 365 EAST MAIN ST, BRENTWOOD, NY 11717-4625
(631) 416-5480
(631) 994-2900
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
180556
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01153171
—
NY
Enumeration date
08/05/2006
Last updated
02/11/2017
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