Individual
DR. STEPHEN WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 562-3346
Mailing address
6718 49TH AVE, WOODSIDE, NY 11377-5912
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
227766
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02424151
—
NY
Enumeration date
12/27/2006
Last updated
09/20/2022
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