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General NPI Number Information
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NPI Number | 1245421718
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Entity Type | Individual
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Provider Name | JAMES WALSH P.A.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 05/01/2015
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Provider Practice Location Address
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Address Line | 175 HIGH ST
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City | NEWTON
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State | NJ
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Zip | 07860-1004
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Country | US
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Telephone | 973-579-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 135 MILTON RD
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City | OAK RIDGE
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State | NJ
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Zip | 07438-9596
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Country | US
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Telephone | 845-661-1089
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 011978
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License Number State | NY
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