Individual
SIDNEY WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
24 NORMAN RD, NEWARK, NJ 07106-2807
(973) 495-9515
Mailing address
24 NORMAN RD, NEWARK, NJ 07106-2807
(973) 495-9515
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CPRS-50493
NJ
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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