NPI 1003238205

Edward S Wallach, LCSWPHD

Practitioner Clinical Social Worker Staten Island, NY

Practice location

Address: 673 Stewart Avenue, Staten Island, NY 10314
Phone: (718) 698-1795
Fax: (718) 698-9357

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence R027293 (NY)

Other Social Worker providers in New York →

Registry record

NPI: 1003238205
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Jan 2014
Record last updated: 8 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.