Doctor Name: | DR. WAYNE DOUGLAS WALDMAN |
NPI Number: | 1255546586 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | N005244 |
Business Practice Address: | 6004 Marathon Pkwy Little Neck, NY - 113622041 |
Business Phone Number: | 7182248888 |
Business Fax Number: | 7182244007 |
Mailing Address: | 6004 Marathon Pkwy, LITTLE NECK |
State: | NY |
Postal Code: | 113622041 |
Phone Number: | 7182248888 |
Fax Number: | 7182244007 |
NPI Enumeration Date: | 05/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | N005244 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |