MR. KEVIN WALLACE


Address: 30 Warren St, Boston, MA 02135-3602
Phone: 6172543800

MR. KEVIN WALLACE (NPI# 1225388457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225388457
Entity Type Individual
Full Name MR. KEVIN WALLACE
Practice Address 30 Warren St
Boston
MA 02135-3602
Mailing Address 555 Washington St
Brighton
MA 02135-2591
Practice Telephone 6172543800
Enumeration Date 2012-09-14
Last Update Date 2012-09-14
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program S50607188 MA Student, Health Care

Other Providers KEVIN WALLACE

NPI Name Taxonomy Address Enumeration
1659760700 Kevin Wallace Naturopath 1700 N Tully Rd Apt G221, Turlock, CA 95380-6879 2015-01-13
1144576919 Kevin Gary Wallace Pharmacist 94 Ladd Ave, Staten Island, NY 10312-1515 2012-07-31
1972750909 Kevin D Wallace Dentist 1200 E Woodhurst Dr Ste A200, Springfield, MO 65804-3745 2008-08-21
1316960131 Kevin Bruce Wallace Dentist 949 N 14th St, Leesburg, FL 34748-3838 2006-07-25
1033619614 Kevin R Wallace Case Manager/Care Coordinator 3620 Stutz Dr, Canfield, OH 44406-9176 2018-02-20
1518391135 Kevin Wallace Massage Therapist 817 Coffee Rd Ste D, Modesto, CA 95355-4241 2013-08-30
1053423285 Kevin R Wallace Dentist 150 E Huron St, Ste 1103, Chicago, IL 60611 2006-09-01
1730128372 Kevin L Wallace Preventive Medicine 925 E Mcdowell Rd, Phoenix, AZ 85006-2502 2006-06-06
1255309258 Kevin Ps Wallace Internal Medicine 1300 Crane St, Menlo Park, CA 94025-4260 2006-03-08
1033195631 Kevin H Wallace Internal Medicine 1350 Hickory St, Melbourne, FL 32901-3224 2005-12-16

Office Location

Street Address 30 WARREN ST
City BOSTON
State MA
Zip Code 02135-3602

Providers in the same location

NPI Name Taxonomy Address Enumeration
1639721798 Nancy Tran Occupational Therapist 30 Warren St, Boston, MA 02135-3602 2019-07-09
1952878399 Anne Hannan Social Worker 30 Warren St, Boston, MA 02135-3602 2018-10-24
1265911390 Lauren Sterlin Physical Therapist 30 Warren St, Boston, MA 02135-3602 2018-08-09
1104345073 Kathleen S Holte Student in an Organized Health Care Education/Training Program 30 Warren St, Boston, MA 02135-3602 2017-09-12
1972022077 Megan Ahnen Student in an Organized Health Care Education/Training Program 30 Warren St, Boston, MA 02135-3602 2017-09-11
1801314463 Katherine Jordan Counselor 30 Warren St, Boston, MA 02135 2017-09-05
1134646334 Sarah Williams Occupational Therapist 30 Warren St, Boston, MA 02135-3602 2017-08-28
1467909671 Jordan Constance Psychologist 30 Warren St, Boston, MA 02135-3602 2016-09-06
1972972081 Olivia Tosi Student in an Organized Health Care Education/Training Program 30 Warren St, Boston, MA 02135-3602 2015-09-18
1033585898 Marcela Teresa Donat Physical Therapist 30 Warren St, Boston, MA 02135-3602 2015-08-17
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699392944 Nur Zeynep Ay Student in an Organized Health Care Education/Training Program 736 Cambridge Street St Elizabeths Medical Center, Graduate Medical Education (diane Giacalone), Boston, MA 02135 2020-07-02
1104470673 Domenique Delucia Counselor 77f Warren Street, Brighton, MA 02135 2019-08-01
1831751684 Meredith Mcghee Audiologist 736 Cambridge Street Smc-8, Brighton, MA 02135 2019-07-02
1730645847 Delphine Alignol Family Medicine 330 Mount St, Cambridge, MA 02135 2019-02-13
1124501960 Ellen Elizabeth Miller Social Worker 44 Mt Vernon St, Brighton, MA 02135 2018-09-07
1710466180 Sharon Pae Acupuncturist 135 Chiswick Rd Bsmt, Brighton, MA 02135 2018-08-07
1750877155 Leonid Sigal Counselor 9 South St Apt 2, Brighton, MA 02135 2018-07-09
1689165425 Brian George Mcguire Dentist 24 Sidlaw Rd, Brighton, MA 02135 2018-05-29
1619467214 Ashley Marie Arbuckle Counselor 77 Waren Street, Building 9, Brighton, MA 02135 2018-05-18
1871098962 Arina Sorokina Dentist Charles River Community Health Center, 495 Western Avenue, Allston, MA 02135 2018-03-29
Find all providers in zip 02135

Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1306447636 Sarah Wieman Student in an Organized Health Care Education/Training Program 16 Blossom St Fl 1, Boston, MA 02114-3104 2020-11-03
1932709938 Brianna Mae Duval Student in an Organized Health Care Education/Training Program 58 Colborne Rd, Boston, MA 02135-4103 2020-10-28
1780281279 Sarah Hamad Alsaggabi Student in an Organized Health Care Education/Training Program 55 Traveler St Apt 1310, Boston, MA 02118-2973 2020-10-07
1821695933 Matthew John Needham Student in an Organized Health Care Education/Training Program 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 2020-10-02
1013524339 Jacqueline Busa Student in an Organized Health Care Education/Training Program Northeastern University 336 Huntington Ave, Boston, MA 02115 2020-09-30
1558978957 Tien-hsin Chang Student in an Organized Health Care Education/Training Program 1 Kneeland Street (tufts University School of Dental Me, Boston, MA 02111 2020-09-29
1417564279 Katherine Rose Brainard Student in an Organized Health Care Education/Training Program 336 Huntington Avenue, Boston, MA 02115 2020-09-25
1962018069 Cara Connors Student in an Organized Health Care Education/Training Program 18 Wiget St Apt 1, Boston, MA 02113-2363 2020-09-23
1023624608 Bernadette Avila Student in an Organized Health Care Education/Training Program 19 Peterborough St Apt 5, Boston, MA 02215-4409 2020-09-19
1588276281 Guoliang Qiao Student in an Organized Health Care Education/Training Program Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 2020-08-24
Find all providers in BOSTON

Competitor

Search similar providers

City BOSTON
Zip Code 02135

Improve Information

Please comment or provide details below to improve the information on MR. KEVIN WALLACE.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches