Organization
MEDICAL ASSOCIATE OF WALL STREET, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN GANDELMAN M.D. (CHIEF EXECUTIVE OFFICER)
(212) 233-3040
Entity
Organization
Contact information
Practice address
6 MAIDEN LN RM 500, NEW YORK, NY 10038-5140
(212) 233-3040
(212) 349-7529
Mailing address
81 HOLLY HILL LN FL 3, GREENWICH, CT 06830-6071
(203) 869-8515
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/15/2012
Last updated
09/20/2022
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