Healthcare Provider Details

I. General information

NPI: 1275705204
Provider Name (Legal Business Name): WALTER F CAMERON JR A PHYSICIAN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 10/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 FRANKLIN AVE SUITE # 214
GARDEN CITY NY
11530-5801
US

IV. Provider business mailing address

520 FRANKLIN AVE SUITE # 214
GARDEN CITY NY
11530-5801
US

V. Phone/Fax

Practice location:
  • Phone: 516-747-7720
  • Fax:
Mailing address:
  • Phone: 516-747-7720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number143826
License Number StateNY

VIII. Authorized Official

Name: DR. WALTER FRANCIS CAMERON JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 516-747-7720