Individual provider Active NPI

Christina Erin Wallace, L.AC.

  • Acupuncturist
  • Tarrytown, NY
National Provider Identifier
1487097937
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
006008 Issued in NY
Practice address
200 S. Broadway
South Building, Suite #2-3
Tarrytown, NY 10591-4500
Phone
(914) 246-0148
NPI assigned
Apr 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 006008 NY Primary

Addresses

Primary practice location

200 S. Broadway
South Building, Suite #2-3
Tarrytown, NY 10591-4500

Mailing address

916 Lyman Ave
Peekskill, NY 10566-1820
Phone (914) 246-0148

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

State licenses

LicenseStateTypeSpecialty
006008NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Christina Wallace Acupuncture PLLC Acupuncturist CurrentSince Dec 12, 2021 Accepting new patients

Locations

200 S Broadway
Ste 2-3
Tarrytown, NY 10591
Phone (914) 246-0148

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1487097937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 LYMAN AVE",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105661820",
            "telephone_number": "914-246-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S. BROADWAY",
            "address_2": "SOUTH BUILDING, SUITE #2-3",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105914500",
            "telephone_number": "914-246-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "CHRISTINA",
        "middle_name": "ERIN",
        "name_prefix": "Ms.",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "006008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarrytown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.