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Individual

ALYSON WALTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 684-8024
Mailing address
951 PHYLLIS DR, BALDWIN, NY 11510-5047
(516) 508-2201

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10078074
PTCB
Enumeration date
10/31/2018
Last updated
10/31/2018
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