Wallace B Kalt Md Pc

NPI 1043476864 - Legal Medicine - 173000000X

NPI Details
NPI 1043476864
Enumeration Date 07/31/2008
Last Updated 07/31/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name WALLACE B WALLACE
Position MEDICAL DOCTOR
Phone (516) 798-3110
Fax (516) 798-3605
Practice Location
930 N BROADWAY
SUITE 3
MASSAPEQUA NY, 11758-2394, US
Phone (516) 798-3110
Fax (516) 798-3605
Business Location
930 N BROADWAY
SUITE 3
MASSAPEQUA NY, 11758-2394, US
Phone (516) 798-3110
Fax (516) 798-3605
Toxanomy
Taxonomy Code 173000000X
License State New York
License Number 077178
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According to our database, Wallace B Kalt Md Pc NPI is 1043476864, taxonomy code is 173000000X and license number is 077178, license state is located at New York. Wallace B Kalt Md Pc physically located at 930 N Broadway, Massapequa NY, 11758-2394. NPI Number 1033115704 has the healthcare provider type.

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1043476864 NPI number is provided on an as is basis without warranty of any kind. 1043476864 is maintained by the National Plan & Provider Enumeration System. The contents of Wallace B Kalt Md Pc are for informational purposes only.