Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 343642 | NY |
NPI | 1003430463 |
---|---|
Provider Name | Mrs. Karolina Walasek |
First Address | Brooklyn, NY 11209-8335 |
Second Address | Brooklyn, NY 11220-2508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2020 |
Last Update Date | 02/06/2020 |