Provider Demographics
NPI:1669871976
Name:NEVILLE E. WALKER, D.O., P.C.
Entity type:Organization
Organization Name:NEVILLE E. WALKER, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEVILLE
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:518-400-0399
Mailing Address - Street 1:PO BOX 203
Mailing Address - Street 2:
Mailing Address - City:DELANSON
Mailing Address - State:NY
Mailing Address - Zip Code:12053-0203
Mailing Address - Country:US
Mailing Address - Phone:518-400-0399
Mailing Address - Fax:518-533-6065
Practice Address - Street 1:526 ALTAMONT AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-1039
Practice Address - Country:US
Practice Address - Phone:518-400-0399
Practice Address - Fax:518-533-6065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY275484OtherNYS LICENSE #