Individual
DR. WILLIAM TODD WALLENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3754 MILITARY RD, NIAGARA FALLS, NY 14305-3517
(716) 298-4330
Mailing address
3754 MILITARY RD, NIAGARA FALLS, NY 14305-3517
(716) 298-4330
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
116615
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00615509
—
NY
01
—
116615
MEDICAL LICENSE #
NY
Enumeration date
07/28/2005
Last updated
03/07/2023
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