Provider Demographics
NPI:1063849008
Name:WALSH, CHRISTINE FRANCES
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:FRANCES
Last Name:WALSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5809
Mailing Address - Country:US
Mailing Address - Phone:516-333-0374
Mailing Address - Fax:516-333-4323
Practice Address - Street 1:307 POST AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2223
Practice Address - Country:US
Practice Address - Phone:516-333-3975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-05
Last Update Date:2013-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058211183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist