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NPI Code Detail

MEDICARE: IMELDA F WALSH RN

MEDICARE: IMELDA F WALSH RN
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
1251E00000XHome Health Agency437049NY

General Provider Information

NPI Number : 1548405624
Entity Type Code : Individual
Provider Name (Legal Business Name) : IMELDA F WALSH RN
Provider Business Mailing Address
First Line : 16 COTTAGE AVE
Second Line :
City : WINGDALE
State : NY
Zip : 12594-1622
Country : US
Telephone Number : 845-832-7361
Fax Number :
Provider Business Practice Location Address
First Line : 360 MAMARONECK AVE
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-1700
Country : US
Telephone Number : 914-682-1480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2008
Last Update Date : 12/03/2008

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