Provider Demographics
NPI:1144263153
Name:WALD, FRANKLIN D (MD)
Entity type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:D
Last Name:WALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 NOTTINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-6754
Mailing Address - Country:US
Mailing Address - Phone:908-647-0527
Mailing Address - Fax:908-647-3416
Practice Address - Street 1:9 NOTTINGHAM WAY
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-6754
Practice Address - Country:US
Practice Address - Phone:908-647-0527
Practice Address - Fax:908-647-3416
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA021125002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC59113Medicare UPIN
NJ050626Medicare ID - Type Unspecified