Individual
DR. CAMARI WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4628 VERNON BLVD STE 506, LONG ISLAND CITY, NY 11101-5352
(917) 747-8519
Mailing address
4628 VERNON BLVD STE 506, LONG ISLAND CITY, NY 11101-5352
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
279402
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
279402
NY
Other
Enumeration date
04/25/2013
Last updated
09/18/2023
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