Individual
CAVALLO F WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13922 PERSHING CRES, JAMAICA, NY 11435-1949
(917) 584-0363
Mailing address
13922 PERSHING CRES, JAMAICA, NY 11435-1949
(917) 584-0363
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TWZRBC986
—
NY
Enumeration date
07/20/2021
Last updated
07/20/2021
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