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General NPI Number Information
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NPI Number | 1134723497
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Entity Type | Individual
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Provider Name | LILY ANN WALSH PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/27/2020
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Last Update Date | 12/23/2022
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Provider Practice Location Address
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Address Line | 333 E 38TH ST FL 6
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City | NEW YORK
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State | NY
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Zip | 10016-2772
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Country | US
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Telephone | 212-598-6010
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Fax |
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Provider Business Mailing Address
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Address Line | 199 2ND ST APT E604
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City | MINEOLA
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State | NY
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Zip | 11501-6003
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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