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1134154792
ALEXANDER JORG WALLE
OZONE PARK, NY
NPI
1134154792
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NY 162148)
Enumeration Date
2006-07-12
Last Update Date
2021-01-04
Business Address
Dr. ALEXANDER JORG WALLE MD PhD
13223 79TH ST
OZONE PARK, NY 11417-1137
Phone number: 718-456-5600
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Mailing Address
Dr. ALEXANDER JORG WALLE MD PhD
PO BOX 211261
WOODHAVEN, NY 11421
Phone number: 718-456-5600
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