Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Wall Street Physician PLLC

Organization Internal Medicine Physician · NPI 1811240112

Wall Street Physician PLLC is an Internal Medicine Physician in New York, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

111 Broadway Ste 402
New York, NY 10006-1901
Phone: (212) 784-0072
Fax: (212) 784-0076
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 1676231 (NY)

Record details

NPI number1811240112
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cathy Carron — President · (212) 784-0072
NPI enumeratedOctober 24, 2012
Last updated in NPPESAugust 15, 2014
Mailing address111 Broadway, Suite 402, New York, NY 10006-1901

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