Individual
DR. JEFFREY D WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
506 LENOX AVE, MLK 12101, NEW YORK, NY 10037-1802
(212) 939-2291
(212) 939-1745
Mailing address
19 BEACH ST, APT 4, NEW YORK, NY 10013-2954
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
127655-1
NY
207RN0300X
Nephrology Physician
23291
WI
Other
Enumeration date
02/13/2006
Last updated
12/09/2019
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