Basic Information
Provider Information
NPI: 1912386871
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHALEN
FirstName: WILLIAM
MiddleName:  
NamePrefix: DR.
NameSuffix: II
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 525 E 68TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100654870
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 525 E 68TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100654870
CountryCode: US
TelephoneNumber: 6469622333
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/26/2015
LastUpdateDate: 03/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X308585NYN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001X308585NYY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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