Individual
DARRYL WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
190 MERCER ST FL 4, NEW YORK, NY 10012-1502
(212) 677-3400
(212) 995-5897
Mailing address
190 MERCER ST FL 4, NEW YORK, NY 10012-1502
(212) 677-3400
(212) 995-5897
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
248038-1
NY
Other
Enumeration date
09/26/2013
Last updated
09/26/2013
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