Active NPI
Danielle N Wallace, RPH
- Pharmacist
- Syracuse, NY
National Provider Identifier
1093998510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 047490
- Practice address
- 329 S Salina St
Suite P
Syracuse, NY 13203 - Phone
- (315) 930-3823
- NPI assigned
- Dec 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 047490 | NY | Primary |
Addresses
Primary practice location
329 S Salina St
Suite P
Syracuse, NY 13203
Mailing address
329 S Salina St
Suite P
Syracuse, NY 13203
Phone (315) 930-3823
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047490 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1093998510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "329 S SALINA ST",
"address_2": "SUITE P",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "13203",
"telephone_number": "315-930-3823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "329 S SALINA ST",
"address_2": "SUITE P",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "13203",
"telephone_number": "315-930-3823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "DANIELLE",
"middle_name": "N",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-06",
"last_updated": "2023-11-08",
"certification_date": "2023-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "047490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.