WALLIE KANISHKA

GLEN COVE, NY
NPI1659045235
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-08-05
Last Update Date2021-08-05
Business Address
WALLIE KANISHKA Physician Assistant
25 HITCHING POST LN
GLEN COVE, NY 11542-1625
Phone number: 801-918-4155
Mailing Address
WALLIE KANISHKA Physician Assistant
25 HITCHING POST LN
GLEN COVE, NY 11542-1625
Phone number: 801-918-4155
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