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NPI Code Detail

MEDICARE: TRACEY WALTON

MEDICARE: TRACEY WALTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor33197NY

General Provider Information

NPI Number : 1427668391
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACEY WALTON
Provider Business Mailing Address
First Line : 1623 KINGS HWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1209
Country : US
Telephone Number : 718-954-3800
Fax Number :
Provider Business Practice Location Address
First Line : 1623 KINGS HWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1209
Country : US
Telephone Number : 718-954-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2020
Last Update Date : 03/15/2026

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Directions to “ TRACEY WALTON ” Practice Location

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