Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | N004733 | NY |
N | 222Z00000X | Podiatrist | N004733 | NY |
Y | 213ES0131X | Foot Surgery | 004733 | NY |
NPI | 1063410470 |
---|---|
Provider Name | Eric G Walter |
First Address | Bronx, NY 10466-2604 |
Second Address | Bronx, NY 10466-2604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2005 |
Last Update Date | 13/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01430560 | (05) | NY |
U42180 | (02) | NY |