Individual
DR. DARREN MARC WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
150 BROADWAY, NEW YORK, NY 10038-4381
(212) 233-2344
Mailing address
9 LEDGEWOOD COMMONS, MILLWOOD, NY 10546-1025
(914) 762-7123
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
005966
NY
Other
Enumeration date
02/19/2007
Last updated
07/08/2007
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