Wallace, Timothy

Wallace, Timothy is an individual health care provider with primary practice located at 450 Clarkson Ave Box 56, Brooklyn NY 11203-2056. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Wallace, Timothy can be contacted via phone (718) 270-1554.

Contact Information

Primary practice address
450 Clarkson Ave Box 56 Brooklyn NY 11203-2056
Phone: (718) 270-1554
Fax: (718) 270-4123
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 004988-1 New York

Profile Details

NPI number 1700850674
LBN Legal business name Wallace, Timothy
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Jul 8th, 2007 - about 19 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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