Individual
DR. THOMAS WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(202) 305-5437
Mailing address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-5437
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
272557
NY
2080P0206X
Pediatric Gastroenterology Physician
Primary
272557
NY
Other
Enumeration date
03/23/2012
Last updated
03/27/2023
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