RYAN J WALLACE (NPI# 1447859624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447859624 |
| Entity Type | Individual |
| Full Name | RYAN J WALLACE |
| Practice Address |
1493 Cambridge St Cambridge MA 02139-1047 |
| Mailing Address |
21 The Laurels Enfield CT 06082-2350 |
| Practice Telephone | 6176651000 |
| Mailing Telephone | 4134547781 |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PH239831 | MA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285070326 | Ryan R Wallace | Physician Assistant | 7226 Crested Butte Dr, Cheyenne, WY 82009-3629 | 2013-05-16 |
| 1477875458 | Ryan Christopher Wallace | Dentist | 420 E 3rd St Ste 1008, Los Angeles, CA 90013-1648 | 2010-02-18 |
| 1922663392 | Ryan Lee Wallace | Student in an Organized Health Care Education/Training Program | 1800 Orleans St, Baltimore, MD 21287-0010 | 2019-05-01 |
| 1760980577 | Ryan M Wallace | Counselor | 117 E 3rd St, Uhrichsville, OH 44683-1818 | 2018-01-26 |
| 1679021497 | Ryan James Wallace | Nurse Practitioner | 525 E Market St, Akron, OH 44304-1619 | 2016-09-21 |
| 1154795078 | Ryan Wallace | Physical Therapist | 5501 N Oracle Rd Ste 101, Tucson, AZ 85704-3850 | 2015-11-16 |
| 1548695075 | Ryan Myles Wallace | Psychiatry & Neurology | 55 Lock St, New Haven, CT 06511 | 2013-09-03 |
| 1316086291 | Ryan C Wallace | Emergency Medicine | 2401 W University Ave, Muncie, IN 47303-3428 | 2007-02-06 |
| 1568420354 | Ryan James Wallace | Physical Therapist | 25241 Elementary Way, Ste 200, Bonita Springs, FL 34135-7883 | 2006-05-02 |
| 1003891920 | Ryan Michael Wallace | Emergency Medical Technician, Basic | 5201 Lee Rd, Buzzards Bay, MA 02542-1313 | 2005-12-14 |
| Street Address |
1493 CAMBRIDGE ST |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02139-1047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871590950 | Blake Cady | Surgery | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2005-07-05 |
| 1144821349 | Christina Marie Harris | Speech-Language Pathologist | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2020-11-04 |
| 1558961128 | Rose M Jacob | Registered Nurse | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2020-10-31 |
| 1174122360 | Emilee Grace Abraham | Speech-Language Pathologist | 1493 Cambridge St, Cambridge, MA 02139-1099 | 2020-10-20 |
| 1790384964 | Jillian Christine Fernandez | Occupational Therapist | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2020-10-20 |
| 1376141606 | Angela Gonzalez | Registered Nurse | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2020-10-09 |
| 1669079646 | Ashley Simmons | Occupational Therapist | 1493 Cambridge St, Cambridge, MA 02139-1099 | 2020-10-03 |
| 1831706159 | Valerie Anne Roberson | Registered Nurse | 1493 Cambridge St, Cambridge, MA 02139-1099 | 2020-09-30 |
| 1578170809 | Deborah Lee Trujillo | Licensed Practical Nurse | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2020-09-30 |
| 1548877087 | Amanda Sousa | Social Worker | 1493 Cambridge St, Cambridge, MA 02139-1099 | 2020-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598316044 | Diane Greenleaf | Registered Nurse | Cha Windsor Clinic, 119 Windsor St, Cambridge, MA 02139 | 2019-09-26 |
| 1730738345 | Martin Bednar | Student in an Organized Health Care Education/Training Program | 350 Massachusetts Avenue, Cambridge, MA 02139 | 2019-09-06 |
| 1861050049 | Rebecca Marie Addison | Dietitian, Registered | 75 Auburn St, Cambridge, MA 02139 | 2019-06-03 |
| 1285103051 | Jenna Halloran | Social Worker | 929 Massaschusetts Ave, Cambridge, MA 02139 | 2018-11-21 |
| 1750859286 | Lisa Marie Keovongsa | Dietitian, Registered | 186 1/2 Hampshire St., Cambridge, MA 02139 | 2018-11-02 |
| 1245714237 | Eleanor Coffin | Occupational Therapist | 1483 Cambridge St, Cambridge, MA 02139 | 2018-09-17 |
| 1649758277 | Sariya Idriss | Social Worker | Cambridge Health Alliance, 1493 Cambridge St., Cambridge, MA 02139 | 2018-08-06 |
| 1538647151 | Ari Pehkonen | Social Worker | Cambridge Health Alliance, Cambridge Hospital, 1493 Cambridge St., Cambridge, MA 02139 | 2018-08-06 |
| 1972080893 | Esther Cazeau | Counselor | 237 Hampshire St., Cambridge, MA 02139 | 2018-07-24 |
| 1528596533 | Adam Liebling | Acupuncturist | 11 Fiske Pl., Cambridge, MA 02139 | 2017-06-03 |
| Find all providers in zip 02139 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265046759 | Anna Lundberg | Pharmacist | 348 Franklin St Apt 4c, Cambridge, MA 02139-3163 | 2020-09-02 |
| 1710599436 | David Robert Podradchik | Pharmacist | 25 Carleton St # E23-196, Cambridge, MA 02142-1323 | 2020-08-24 |
| 1790339521 | Erica Liu | Pharmacist | 80 Fawcett St, Cambridge, MA 02138-1145 | 2019-07-30 |
| 1659727808 | William Andrew Kuebler | Pharmacist | 61690 Southgate Pkwy, Cambridge, OH 43725 | 2016-05-06 |
| 1629451059 | Emily Jane Hein | Pharmacist | 701 S Dellwood, Cambridge, MN 55008-1920 | 2015-07-02 |
| 1043652605 | Stacy Lynn Fitzgerald | Pharmacist | 625 Massachusetts Avenue, Cambridge, MA 02139 | 2013-07-24 |
| 1851731822 | Gabriella Maree Pugliese | Pharmacist | 822 Somerville Ave, Cambridge, MA 02140 | 2013-07-04 |
| 1316213325 | Victoria Liu | Pharmacist | 1035 Cambridge St Ste 232331, Cambridge, MA 02141-1057 | 2012-03-25 |
| 1114200821 | Chaicharn Luangkamthorn | Pharmacist | 211 Alewife Brook Pkwy, Cambridge, Cambridge, MA 02138-1101 | 2011-09-20 |
| 1134417306 | Alexandra Polito | Pharmacist | 1035 Cambridge St Ste 23, Cambridge, MA 02141-1154 | 2011-07-21 |
| Find all providers in CAMBRIDGE | ||||
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| 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.