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

Antaeus T Waller

Individual provider Registered Nurse · NPI 1659233344

Antaeus T Waller is a Registered Nurse in Long Island City, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2025

Practice location Address checks out

2811 Queens Plz N
Long Island City, NY 11101-4172
Phone: (718) 391-8300
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 996271 (NY)

Record details

NPI number1659233344
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedDecember 1, 2025
Last updated in NPPESDecember 1, 2025
Certification dateDecember 1, 2025

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