Wallie Kanishka, PHYSICIANASSISTANT
Wallie Kanishka, PHYSICIANASSISTANT is a Student in an Organized Health Care Education/Training Program in Glen Cove, New York. Practices as a sole proprietor. Registered with an NPI since 2021.
- In the registry since
- 2021
Practice location Address checks out
25 Hitching Post LnGlen Cove, NY 11542-1625
Phone: (801) 918-4155
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1659045235 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PHYSICIANASSISTANT |
| Sole proprietor | Yes |
| NPI enumerated | August 5, 2021 |
| Last updated in NPPES | August 5, 2021 |
| Certification date | August 5, 2021 |
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