Individual
DR. WALTER LEO NIEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 N AIRMONT RD, STE 10, SUFFERN, NY 10901-5103
(845) 357-5525
(845) 357-1613
Mailing address
11 N AIRMONT RD, STE 10, SUFFERN, NY 10901-5103
(845) 357-5525
(845) 357-1613
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
132973
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00483358
—
NY
01
—
CPN-N 227967
WCB RATING, AUTH. #
NY
Enumeration date
07/14/2006
Last updated
11/01/2017
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