Individual
KENNETH JAY WALD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
140 E 80TH ST, RETINA ASSOCIATES OF NEW YORK, P.C., NEW YORK, NY 10021-0306
(212) 772-0600
(212) 517-8028
Mailing address
140 E 80TH ST, RETINA ASSOCIATES OF NEW YORK, P.C., NEW YORK, NY 10021-0306
(212) 772-0600
(212) 517-8028
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
174795
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01516783
—
NY
Enumeration date
09/02/2005
Last updated
07/08/2007
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