National Provider Identifier
Rebecca Wallace
Rebecca Wallace is listed in the NPPES registry with a primary specialty of Specialist in Victor, NY and a listed phone number of (585) 924-7207.
Profile Overview
- NPI
- 1083379705
- Provider Type
- Individual
- Primary Specialty
- Specialist
- Enumeration Date
- November 08, 2021
- Last Updated
- November 08, 2021
Practice Location
- 590 Fishers Station Dr Ste 130
- Victor, NY 14564-9744
Phone: (585) 924-7207
Mailing Address
- PO Box 142
- Mendon, NY 14506-0142
Specialties
- Specialist (174400000X)
Full Record
- NPI
- 1083379705
- Entity Type
- Individual
- Last Name
- Wallace
- First Name
- Rebecca
- Mailing Street Address
- PO Box 142
- Mailing City
- Mendon
- Mailing State
- NY
- Mailing ZIP Code
- 14506-0142
- Mailing Country
- US
- Mailing Phone
- (585) 355-9713
- Practice Street Address
- 590 Fishers Station Dr Ste 130
- Practice City
- Victor
- Practice State
- NY
- Practice ZIP Code
- 14564-9744
- Practice Country
- US
- Practice Phone
- (585) 924-7207
- Enumeration Date
- November 08, 2021
- Last Updated
- November 08, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- November 08, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Specialist (174400000X)