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Contact Information

JESSICA F WALZ, PA
79 MIDDLEVILLE RD
NORTHPORT, NY11768-2200
 Phone: 443-812-0141
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JESSICA F WALZ · (Female)

NPI # 1669544292
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 11/15/2006
Last updated 05/29/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • MD License # C002646
  • ME License # PA001069
  • NY License # 010622
Hospital affiliation(s)
  • BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER - (Acute Care)
    101 HOSPITAL ROAD
    PATCHOGUE, NY 11772
  • ST JOSEPH HOSPITAL - (Acute Care)
    4295 HEMPSTEAD TURNPIKE
    BETHPAGE, NY 11714
  • UNIVERSITY HOSPITAL ( STONY BROOK ) - (Acute Care)
    HEALTH SCIENCES CENTER SUNY
    STONY BROOK, NY 11794
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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