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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. STACEY MARIE WALLACE

Active Sole Proprietor

MS. STACEY MARIE WALLACE is a Specialist healthcare provider located in FREDONIA, New York. NPI 1700149838 is currently active in the NPPES registry. Verify at CMS.

Specialist · FREDONIA, NY

Registration Details

NPI Number
1700149838
Provider Type
Individual
Gender
Female
NPI Issued
Jun 22, 2012 (13.96493800757 yrs)
Last Updated
Jun 22, 2012
License
374992091 (NY)
Sole Proprietor
Yes

Practice Information

Address
75 CHESTNUT ST
FREDONIA, NY, 140631630
Browse NY providers · Browse ZIP 14063
Phone
7166722731
Primary Specialty
Specialist
174400000X

Other Specialist Providers in FREDONIA, NY

Name Credential NPI
WILLIAM J KUWIK II LMT 1407002421
MRS. JULIE LYNN FORTNER MSED 1215290911
MS. DIANNE KATHLEEN BUYER M.S. 1467716779
MRS. MARY SUE VOGEL SPECIAL EDUCATION TE 1740533009
MISS DEVON DOLCE 1316291750
KIMBERLY MARINO-ALGUIRE 1801230826
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.