KISHA WALLACE

NEW YORK, NY
NPI1417433939
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: NY  F308252)
Enumeration Date2018-07-17
Last Update Date2021-06-09
Business Address
KISHA WALLACE
1 GUSTAVE L LEVY PL
NEW YORK, NY 10029-6504
Phone number: 212-241-6500
Mailing Address
KISHA WALLACE
150 E 42ND ST # 3000
NEW YORK, NY 10017-5612
Phone number: 646-605-8119
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