Dr. Henrietta Wallace, M.D.
Obstetrics & Gynecology in New Hyde Park, NY. Individual provider (NPI-1).
NPI number1467585380
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1467585380
- Entity type
- Individual (NPI-1)
- Name
- Dr. Henrietta Wallace
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 13, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 115850 | NY | Yes |
Practice location
2500 Marcus AveNew Hyde Park, NY 11042-1018
Phone 516-437-8300 · Fax 516-437-3250
Mailing address
2500 Marcus AveNew Hyde Park, NY 11042-1018
Phone 516-437-8300 · Fax 516-437-3250
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