Megan Wallace

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

017755-1 Issued in NY

Practice address

162 W 72ND St
5TH Floor
New York, NY 10023-3300

Phone

(212) 721-0208

NPI assigned

Jul 9, 2014

Last updated

Jul 9, 2014By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pollack & Associates, PT, OT & SLP, PLLC

  • Physical Therapy Clinic/Center
  • New York, NY
  • NPI 1700129152
  NPD (past)

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1306252473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 E 27TH ST APT 10N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169254",
            "telephone_number": "631-371-9986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 W 72ND ST",
            "address_2": "5TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100233300",
            "telephone_number": "212-721-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "017755-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208311672",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mario James Wallace, PT, DPT
• Marisa I Wallace, DNP, FNP-BC
• Mark Edward Wallace, M.D.
• Matthew Alexander Wallace, P.A.
• Maureen Elizabeth Wallace, PH.D.
• Meri Diane Wallace, LCSW
• Michelle Wallace
• Nancy E Wallace, LMSW
• Nathan John Wallace, MD
• Norah Suzanne Wallace

• Occupational Therapist in New York, NY
• Providers in New York, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; 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.