Wales Clinic Center LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WALES CLINIC CENTER LLC

Practice address

538 Wales Ave
Bronx, NY 10455-4510

Phone

(347) 716-3865

Fax

(347) 716-3864

NPI assigned

Feb 14, 2024

Last updated

Feb 14, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dalia Polanco

Title

Owner

Phone

(917) 224-5270

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1033974522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 WALES AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554510",
            "telephone_number": "347-716-3865",
            "fax_number": "347-716-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 WALES AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554510",
            "telephone_number": "347-716-3865",
            "fax_number": "347-716-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALES CLINIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "POLANCO",
        "authorized_official_first_name": "DALIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-224-5270"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill S. Waldman, M.D.
• Mel Waldman, PHD
• Ryan Waldman, DPT
• Stephanie Lee Waldman, PA-C
• Khadijah Waldron, MS ED
• Wales Clinic LLC
• Walgreen Co (Walgreens #19196)
• Walgreen Co (Walgreens #17828)
• Walgreen Co (Walgreens #13120)
• Walgreen Co (Walgreens #18988)

• Internal Medicine Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.