Individual
MS. ELEONORA JOHANNA WALCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
205 E 64TH ST, SUITE 402, NEW YORK, NY 10021-6635
(212) 759-4460
Mailing address
74 HURON ST, APT 4R, BROOKLYN, NY 11222-1323
(973) 768-2728
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
011226
NY
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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