Wallace, James M

Wallace, James M is an individual health care provider with primary practice located at 10 Office Park Way , Pittsford NY 14534. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Wallace, James M can be contacted via phone (505) 249-6220.

Contact Information

Primary practice address
10 Office Park Way Pittsford NY 14534
Phone: (505) 249-6220
Fax: (585) 586-5512
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 185559 New York
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 185559 New York
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 185559-1 New York

Profile Details

NPI number 1649369976
LBN Legal business name Wallace, James M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Jul 6th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649369976 NPPES
New York Other EXCELLUS BCBS 2006
New York MEDICAID 01685092 2006
New York Other PREFERRED CORE 2006

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