Individual
MR. BRENDAN WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 562-4970
Mailing address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020572
NY
Other
Enumeration date
01/26/2017
Last updated
01/26/2017
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