Individual
DR. MARC KENNETH WALLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1901 1ST AVE, RM 12A1, NEW YORK, NY 10029-7404
(212) 423-6614
(212) 423-7913
Mailing address
1901 1ST AVE, RM 12A1, NEW YORK, NY 10029-7404
(212) 423-6614
(212) 423-7913
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
185118
NY
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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