Individual provider · Type 1 NPI

William Vanderwall, P.A.-C

Surgical Physician Assistant · Brooklyn, NY

NPI number 1205123783 Active

Practice location

121 Dekalb Ave
Brooklyn, NY 11201-5425

Call (718) 250-8000 Map

Mailing address

1288 1st Ave Apt 5FS
New York, NY 10021-5568

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X014744 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1205123783

William Vanderwall, P.A.-C's National Provider Identifier is 1205123783, issued on Jul 5, 2011. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Brooklyn, NY. The record was last updated on Jul 5, 2011.