Individual
MALLORY WATZKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
703 HARVEST WAY, SAUGERTIES, NY 12477-4564
(845) 417-8203
Mailing address
703 HARVEST WAY, SAUGERTIES, NY 12477-4564
(845) 417-8203
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
760343
NY
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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