Individual
KIM GABRIELLE WALLENSTEIN
Active
Individual
KIM GABRIELLE WALLENSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
257433
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03254340
—
NY
Enumeration date
04/13/2007
Last updated
12/06/2012
Update your record
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