Mr Kevin Alan Wall, FNP | |
200 Front St Ste C, Vestal, NY 13850-1559 | |
(607) 239-5694 | |
Not Available |
Full Name | Mr Kevin Alan Wall |
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Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 200 Front St Ste C, Vestal, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386292357 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 344995 (New York) | Primary |
Entity Name | Brookview Medical Associates Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1871965855 PECOS PAC ID: 9537420450 Enrollment ID: O20180309000532 |
Mailing Address | Practice Location Address |
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Mr Kevin Alan Wall, FNP 3011 State Route 41, Cincinnatus, NY 13040-2215 Ph: (607) 345-9992 | Mr Kevin Alan Wall, FNP 200 Front St Ste C, Vestal, NY 13850-1559 Ph: (607) 239-5694 |
Ying Fang Zhao, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 404 Apine Drive, Vestal, NY 13850 Phone: 917-238-7372 | |
Ms. Kathryn Ellen Ericksen, GNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3700 Old Vestal Rd, Vestal, NY 13850 Phone: 607-221-2745 | |
Susan Wenzinger, ANPC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4513 Old Vestal Rd, Vestal, NY 13850 Phone: 607-729-7001 | |
Erica Tokos, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4417 Vestal Pkwy E, Vestal, NY 13850 Phone: 607-729-2144 Fax: 607-729-2145 | |
Chloe A Pusey, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4104 Vestal Rd, Vestal Executive Park Suite 203, Vestal, NY 13850 Phone: 607-797-9036 Fax: 607-798-0601 | |
Aline Stabler, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4417 Vestal Pkwy E, Vestal, NY 13850 Phone: 607-729-2144 Fax: 607-729-2145 | |
Maggie Ross, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1938 Cole Pl, Vestal, NY 13850 Phone: 607-321-9798 |