Individual
ERIK WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
434 UNION BLVD, WEST ISLIP, NY 11795
(631) 238-3067
(631) 458-1041
Mailing address
434 UNION BLVD, WEST ISLIP, NY 11795-3104
(631) 238-3067
(631) 458-1041
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
23 019235
NY
363A00000X
Physician Assistant
P99582
NY
Other
Enumeration date
09/29/2015
Last updated
07/18/2018
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