MEDICARE: AUDREY M WALKER MD

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
1	2084P0800X	Psychiatry Physician	173452	NY

General Provider Information

NPI Number	:	1760519888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY M WALKER MD

Provider Business Mailing Address
First Line	:	24 COVENTRY LN
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10805-3004
Country	:	US
Telephone Number	:	718-920-2141
Fax Number	:	718-882-3185

Provider Business Practice Location Address
First Line	:	3331 BAINBRIDGE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2801
Country	:	US
Telephone Number	:	718-920-2141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	07/08/2007

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