Individual
RUTH SARAI WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
270-05 76TH AVE, NEW HYDE PARK, NY 11040-1402
(631) 968-3000
Mailing address
270-05 76TH AVE, NEW HYDE PARK, NY 11040-1402
(718) 470-7499
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
021632-1
NY
Other
Enumeration date
11/06/2017
Last updated
04/22/2020
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