Individual
DR. JOSEPH BLAKE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-8504
Mailing address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 305-8504
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
321287
NY
Other
Enumeration date
03/22/2021
Last updated
07/08/2024
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