Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 143826 | NY |
NPI | 1114926540 |
---|---|
Provider Name | Dr. Walter Francis Cameron JR. |
First Address | Garden City, NY 11530-5801 |
Second Address | Garden City, NY 11530-5801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 09/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A63165 | (02) | NY |