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NPI Code Detail

MEDICARE: ERIC G WALTER DPM

MEDICARE: ERIC G WALTER DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatristN004733NY
2213ES0131XFoot Surgery Podiatrist004733NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063410470
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC G WALTER DPM
Provider Business Mailing Address
First Line : 600 E 233RD ST
Second Line : SUITE 3
City : BRONX
State : NY
Zip : 10466-2604
Country : US
Telephone Number : 718-920-2060
Fax Number : 718-920-6889
Provider Business Practice Location Address
First Line : 600 E 233RD ST
Second Line : SUITE 3
City : BRONX
State : NY
Zip : 10466-2604
Country : US
Telephone Number : 718-920-2060
Fax Number : 718-920-6889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2005
Last Update Date : 10/13/2011

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Directions to “ ERIC G WALTER DPM” Practice Location

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