Healthcare Provider Details
I. General information
NPI: 1588694095
Provider Name (Legal Business Name): CHRISTOPHER E WALSH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1190 5TH AVENUE GUGGENHEIM PAV MT SINAI HOSP RUTTENBERG TREATMENT CTR
NEW YORK NY
10029
US
IV. Provider business mailing address
1 GUSTAVE L LEVY PLACE BOX 3000 MOUNT SINAI DEPARTMENT OF MEDICINE
NEW YORK NY
10029
US
V. Phone/Fax
- Phone: 212-241-6756
- Fax: 212-423-0522
- Phone: 212-987-3100
- Fax: 212-731-5210
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 226631 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: