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General NPI Number Information
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NPI Number | 1356371629
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Entity Type | Individual
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Provider Name | WALTER RALPH HOLLAND P.T.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 211 W 71ST ST
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City | NEW YORK
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State | NY
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Zip | 10023-3766
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Country | US
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Telephone | 212-721-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 35 W 92ND ST APT. 7G
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City | NEW YORK
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State | NY
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Zip | 10025-7639
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Country | US
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Telephone | 212-280-0275
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0087433
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License Number State | NY
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