Individual
DR. SUSAN WALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
421 HUGUENOT ST, SUITE 44, NEW ROCHELLE, NY 10801-7004
(914) 235-3065
Mailing address
421 HUGUENOT ST, SUITE 44, NEW ROCHELLE, NY 10801-7004
(914) 235-3065
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
249294
NY
207RR0500X
Rheumatology Physician
Primary
249294
NY
Other
Enumeration date
03/27/2007
Last updated
03/12/2012
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