Darryl Wall, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

248038-1 Issued in NY

Practice address

190 Mercer St FL 4
New York, NY 10012-1502

Phone

(212) 677-3400

Fax

(212) 995-5897

NPI assigned

Sep 26, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Greenwich House Inc

  • Adult Psychiatric/Mental Health Registered Nurse
  • New York, NY
  • NPI 1730207119
  NPD (past)

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1255767976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 MERCER ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100121502",
            "telephone_number": "212-677-3400",
            "fax_number": "212-995-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 MERCER ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100121502",
            "telephone_number": "212-677-3400",
            "fax_number": "212-995-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "DARRYL",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-26",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "248038-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wall Street Physician PLLC
• Wall Street Podiatry Care PC
• Wall Street Podiatry PC
• Wall Street Psychologists PLLC
• Wall Street Wellness Chiropractic P.C.
• Edin Victoria Wall, MSW
• Emma Wall, LMHC
• Joseph Blake Wall, MD
• Lindsay Wall, PHARMACIST
• Lindsey E Wall, NP

• Licensed Practical Nurse in New York, NY
• Providers in New York, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.