Kanishka, Wallie

Kanishka, Wallie is an sole proprietor health care provider with primary practice located at 25 Hitching Post Ln , Glen Cove NY 11542-1625. He recently has only one registered license in Student, Health Care / Student in an Organized Health Care Education/Training Program, which is considered as his primary health care specialty. Kanishka, Wallie can be contacted via phone (801) 918-4155.

Contact Information

Primary practice address
25 Hitching Post Ln Glen Cove NY 11542-1625
Fax:
Website:

Health care specialties

Profile Details

NPI number 1659045235
LBN Legal business name Kanishka, Wallie
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2021
Last updated Aug 5th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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