Stanford Lee Walker, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

180556 Issued in NY

Practice address

South Brookhaven Health Center
365 East Main St
Patchogue, NY 11772

Phone

(631) 854-1307

Fax

(631) 854-1310

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: stan.walker.1@33428.direct.athenahealth.com

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486771200000",
    "number": "1184633307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1869 BRENTWOOD RD",
            "address_2": "365 EAST MAIN ST",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174625",
            "telephone_number": "631-416-5480",
            "fax_number": "631-994-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTH BROOKHAVEN HEALTH CENTER",
            "address_2": "365 EAST MAIN ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-854-1307",
            "fax_number": "631-854-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "STANFORD",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2017-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "180556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01153171",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia A Volpe, LCSW-R
• Diane Elizabeth Wahne, PMHNP
• Eyal Dov Waldman, D.M.D.
• Walgreen Co
• Walgreen Co
• Amy Rachel Walsh, RPAC
• Kathryn Rose Walter
• Gabrielle Nicole Walters, MS, PA-C
• Janeen L Walthall
• Mica Walthall, LPN

• Obstetrics & Gynecology Physician in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2017; 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.