Individual provider · Type 1 NPI

James Richard Wallace, MD

Student in an Organized Health Care Education/Training Program · Brooklyn, NY

NPI number 1699096594 Active

Practice location

4802 10th Avenue
Brooklyn, NY 11209

Call (718) 283-8397 Map

Fax (718) 283-8498

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1699096594

James Richard Wallace, MD's National Provider Identifier is 1699096594, issued on Jun 15, 2010. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Brooklyn, NY. The record was last updated on Jun 15, 2010.