Provider Demographics
NPI:1417241951
Name:ROBERT S.WALSKY MD, PA
Entity Type:Organization
Organization Name:ROBERT S.WALSKY MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSKY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:201-967-1105
Mailing Address - Street 1:452 OLD HOOK RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1381
Mailing Address - Country:US
Mailing Address - Phone:201-967-1105
Mailing Address - Fax:201-967-1272
Practice Address - Street 1:452 OLD HOOK RD
Practice Address - Street 2:SUITE 302
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1381
Practice Address - Country:US
Practice Address - Phone:201-967-1105
Practice Address - Fax:201-967-1272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty