Wallenstein, Kim Gabrielle

Wallenstein, Kim Gabrielle is an individual health care provider with primary practice located at 725 Irving Ave Suite 401, Syracuse NY 13210-1603. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as her primary health care specialty. Wallenstein, Kim Gabrielle can be contacted via phone (315) 464-2878.

Contact Information

Primary practice address
725 Irving Ave Suite 401 Syracuse NY 13210-1603
Phone: (315) 464-2878
Fax: (315) 464-2879
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 257433 New York

Profile Details

NPI number 1518181957
LBN Legal business name Wallenstein, Kim Gabrielle
Credentials M.D., PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2007
Last updated Dec 6th, 2012 - about 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1518181957 NPPES
New York MEDICAID 03254340

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