Individual provider · Type 1 NPI

Zichariea Z. Wallace, PA

Surgical Physician Assistant · Rockville Centre, NY

NPI number 1225128069 Active

Practice location

1000 N Village Ave., Mercy Medical Center
Rockville Centre, NY 11570

Call (516) 705-2525 Map

Fax (516) 705-6969

Mailing address

1003 Steele Blvd
Baldwin, NY 11510-4444

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X010776 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1225128069

Zichariea Z. Wallace, PA's National Provider Identifier is 1225128069, issued on Oct 13, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Rockville Centre, NY. The record was last updated on Oct 10, 2011.