Wallace Russell Jenkins
MD | Pediatric Adolescent Medicine | Male
Wallace Russell Jenkins, MD is a Valhalla, New York based Pediatric doctor with medical specialization in
Pediatric Adolescent Medicine.
Current practice location of Wallace Russell Jenkins is
503 Grasslands Rd, Ste 200, Valhalla, New York - 10595. He can be contacted on phone at
914-304-5288 and fax number 914-345-1755.
Wallace Russell Jenkins is a sole proprietor of his business.
NPI number (Unique professional ID) for Wallace Russell Jenkins is
1487654653 which was assigned by NPPES on 28 Jul, 2005 and it was last updated on 23 Jul, 2013.
Wallace Russell Jenkins license number is
183800 for Pediatrics Adolescent Medicine (2080A0000X) in New York.
Wallace Russell Jenkins specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Wallace Russell Jenkins basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Wallace Russell Jenkins |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Wallace Russell Jenkins address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 503 Grasslands Rd, Ste 200
Valhalla, NY, 10595
United States |
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| Phone Number : | 914-304-5288 |
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| Fax Number : | 914-345-1755 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1487654653 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 28 Jul, 2005 |
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| Last Updated On : | 23 Jul, 2013 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Wallace Russell Jenkins are as mentioned. Primary taxonomy code for Wallace Russell Jenkins, MD is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 183800 | NY |
Legacy Identifiers:
Other legacy medical identifiers of Wallace Russell Jenkins such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 01210104 | MEDICAID | NY | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 503 Grasslands Rd, Ste 200
Valhalla, NY, 10595-1503
United States |
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| Phone Number : | 914-304-5288 |
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| Fax Number : | 914-345-1755 |
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Business Location:
Patients can refer following map for directions to
Wallace Russell Jenkins practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.