Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL WALL
Active Sole ProprietorPsychiatric/Mental Health Clinical Nurse Specialist · LINDENHURST, NY
Registration Details
- NPI Number
- 1083300123
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 12, 2023 (3.0292542910804 yrs)
- Last Updated
- Apr 12, 2023
- License
-
447785 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
LINDENHURST MIDDLE SCHOOL350 SOUTH WELLWOOD AVELINDENHURST, NY, 11757Browse NY providers · Browse ZIP 11757
- Phone
- 6318673510
- Primary Specialty
-
Psychiatric/Mental Health Clinical Nurse Specialist
364SS0200X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.