Individual provider · Type 1 NPI

Wallace Llera, MD

Adult Medicine Physician · Philadelphia, PA

NPI number 1013990332 Active

Practice location

401-55 W Allegheny Ave
Philadelphia, PA 19133-3644

Call (215) 291-2500 Map

Fax (215) 291-2587

Mailing address

1412 Fairmount Ave
Philadelphia, PA 19130-2908

Specialties and licenses

TaxonomyCodeLicense
Adult Medicine Physician Primary 207QA0505XMD038236L (PA)

Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.

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About NPI 1013990332

Wallace Llera, MD's National Provider Identifier is 1013990332, issued on Nov 21, 2005. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Philadelphia, PA. The record was last updated on Jun 7, 2011.