Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 135661 | NY |
N | 207RG0300X | Geriatric Medicine | 135661 | NY |
NPI | 1033214358 |
---|---|
Provider Name | Dr. Walter Michael Kobialka |
First Address | Wilton, CT 06897-1804 |
Second Address | Stamford, CT 06905-5315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 08/07/2007 |