Individual
JOEL J WALLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222 E 19TH ST, 1D, NEW YORK, NY 10003-2607
(212) 995-7200
(212) 979-3544
Mailing address
222 E 19TH ST, 1D, NEW YORK, NY 10003-2607
(212) 995-7200
(212) 979-3544
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
128307
NY
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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