Individual
CHAYA D WALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4819 14TH AVE, BROOKLYN, NY 11219-3119
(718) 438-0707
Mailing address
1965 52ND ST, BROOKLYN, NY 11204-1732
(917) 754-7754
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
012036
NY
Other
Enumeration date
10/15/2007
Last updated
10/15/2007
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