Individual
MISS DIANA WALSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
177 FORT WASHINGTON AVE, NEW YORK, NY 10032-3733
(212) 305-2500
Mailing address
160 W 73RD ST, APT 1D, NEW YORK, NY 10023-3012
(781) 248-8165
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
015104
NY
Other
Enumeration date
09/15/2011
Last updated
03/17/2015
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