Individual provider · Type 1 NPI
Wallace Russell Jenkins, MD
Pediatric Adolescent Medicine Physician · Valhalla, NY
NPI number
1487654653
Active
Practice location
503 Grasslands Rd, Ste 200
Valhalla, NY 10595
Fax (914) 345-1755
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Adolescent Medicine Physician Primary | 2080A0000X | 183800 (NY) |
Pediatric Adolescent Medicine Physician: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
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About NPI 1487654653
Wallace Russell Jenkins, MD's National Provider Identifier is 1487654653, issued on Jul 28, 2005. The primary taxonomy on file is Pediatric Adolescent Medicine Physician (2080A0000X), and the practice location is in Valhalla, NY. The record was last updated on Jul 23, 2013.