Waller, Giacomo Colver

Waller, Giacomo Colver is an individual health care provider with primary practice located at 19 E 98Th St, 7Th Fl Ste A, Box #1259, Ny NY 10029-6574. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Waller, Giacomo Colver can be contacted via phone (212) 241-0949.

Contact Information

Primary practice address
19 E 98Th St, 7Th Fl Ste A, Box #1259 Ny NY 10029-6574
Phone: (212) 241-0949
Fax: (212) 534-2654
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 125.077143 Illinois
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 125.077143 Illinois
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X Georgia
Allopathic & Osteopathic Physicians / Surgery 208600000X 322610 New York

Profile Details

NPI number 1801391438
LBN Legal business name Waller, Giacomo Colver
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2018
Last updated Jul 23rd, 2023 - about 2 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 1801391438 NPPES
Illinois Other 125.077143 ILLINOISE DFPR
Illinois Other 322610 ILLINOISE DFPR

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