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Petagay Walters

Specialist in Brooklyn, NY. Individual provider (NPI-1).

NPI number1154242535
StatusActive
Last updated in NPPESAug 5, 2026

Details

NPI
1154242535
Entity type
Individual (NPI-1)
Name
Petagay Walters
Sex
Female
Sole proprietor
No
Enumeration date
Jul 22, 2026
Certification date
Aug 5, 2026
Last updated
Aug 5, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
174400000X Specialist––Yes

Practice location

1525 Newkirk Ave
Brooklyn, NY 11226-6523

Phone 718-287-5362

Mailing address

1414 Avenue K
Brooklyn, NY 11210-4964

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