Rebecca Wallace

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

310362 Issued in NY

Practice address

12 Demarest Rd
Chestnut Ridge, NY 10977-6517

Phone

(845) 323-5257

NPI assigned

Jul 27, 2012

Last updated

Jul 27, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1285980250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 DEMAREST RD",
            "city": "CHESTNUT RIDGE",
            "state": "NY",
            "postal_code": "109776517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 DEMAREST RD",
            "city": "CHESTNUT RIDGE",
            "state": "NY",
            "postal_code": "109776517",
            "telephone_number": "845-323-5257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "310362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Rivkah Vaiselbuh, M.D.
• Frank Anthony Vigilante, R.PH.
• Cheryl Volpe
• Christine Walker
• Edward Martin Walker, PH.D.
• Shaindy Weinstein, OTR/L
• Hillary Wells, LAC
• Annmarie Wilhelm, COTA
• William Paul Faist Volunteer Ambulance Corps
• Kimberly Monique Williams, RN

• Licensed Practical Nurse in Chestnut Ridge, NY
• Providers in Chestnut Ridge, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.