IndividualActive
Jacob Wallach, DPM
NPI 1154437358 · Primary Podiatric Medicine Podiatrist · Brooklyn, NY
Provider details
- NPI number
- 1154437358
- Entity type
- Individual
- Primary specialty
- Primary Podiatric Medicine PodiatristPodiatric Medicine & Surgery Service Providers
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- Yes
- License
- N005523 (NY)
Practice location
2424 Kings Hwy
Ste 1g
Brooklyn, NY 11229-1641
Phone: (718) 258-9572
Fax: (718) 258-7216
Mailing address
51 White Dr
Cedarhurst, NY 11516-2630
Registry dates
- Enumerated
- 2006-08-21
- Last updated
- 2022-01-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.