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General NPI Number Information
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NPI Number | 1235417999
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Entity Type | Individual
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Provider Name | HEATHER LYNN WALCZYK PHARM.D., R.PH.
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Gender | Female
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Dates
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Enumeration Date | 07/29/2011
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Last Update Date | 07/29/2011
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Provider Practice Location Address
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Address Line | 585 SCHENECTADY AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-1809
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Country | US
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Telephone | 716-698-4987
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Fax |
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Provider Business Mailing Address
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Address Line | 2217 CATON AVE APARTMENT #4C
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City | BROOKLYN
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State | NY
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Zip | 11226-2507
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Country | US
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Telephone | 716-698-4987
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 055794
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License Number State | NY
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