Individual
MRS. NANCY ELIANA WALLACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11607 METROPOLITAN AVE STE 101, RICHMOND HILL, NY 11418-1018
(718) 850-9225
(718) 850-9226
Mailing address
11607 METROPOLITAN AVE STE 101, RICHMOND HILL, NY 11418-1018
(718) 850-9225
(718) 850-9226
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
224297
NY
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
224297
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02244920
—
NY
Enumeration date
08/31/2006
Last updated
09/21/2023
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