DAVID WALLACE (NPI# 1720646672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720646672 |
| Entity Type | Individual |
| Full Name | DAVID WALLACE |
| Credential | PA-C |
| Practice Address |
1 Hospital Plz Stamford CT 06902-3602 |
| Practice Telephone | 2032761000 |
| Mailing Telephone | 2032761000 |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2020-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
4572 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Hospital Plz, Stamford, CT 069023602 | 2032761000 | |
| 34 Maple St, Norwalk, CT 068503894 | 2038522000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700327061 | David Wallace | Student in an Organized Health Care Education/Training Program | 24606 Mosquero Ln, Mission Viejo, CA 92691-4913 | 2017-03-19 |
| 1265743595 | David R Wallace Jr. | Radiology | 200 W Arbor Dr # Mc0834, Department of Radiology, San Diego, CA 92102-0834 | 2010-07-01 |
| 1386868487 | David Stuart Wallace | Chiropractor | 2330 Highway 94 South Outer Rd, Saint Charles, MO 63303-8301 | 2007-04-12 |
| 1649343641 | David Michael Wallace | Chiropractor | 112 W Grand Ave, Rainbow City, AL 35906-3233 | 2006-11-16 |
| 1932193604 | David Wallace | Anesthesiology | 738 Golden Pheasant Dr, Draper, UT 84020-8454 | 2005-09-08 |
| 1386646206 | David Allen Wallace | Dentist | 206 S Walker St, Princeton, WV 24740-2747 | 2005-08-11 |
| 1295736809 | David B. Wallace | Radiology | 325 N Highland Ave, Provena Mercy Medical Center, Aurora, IL 60506-3811 | 2005-08-04 |
| 1679576276 | David Alan Wallace | Ophthalmology | 11600 Wilshire Blvd, Ste 200, Los Angeles, CA 90025-1782 | 2005-05-27 |
| 1619596335 | David Alexander Wallace | Student in an Organized Health Care Education/Training Program | 920 Madison Ave Ste 447, Memphis, TN 38103-3438 | 2020-04-13 |
| 1396364402 | David Carter Wallace | Student in an Organized Health Care Education/Training Program | 620 Shadow Ln, Las Vegas, NV 89106-4119 | 2020-04-09 |
| Street Address |
1 HOSPITAL PLZ |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902-3602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972842 | Brittany Charney | Nurse Practitioner | 1 Hospital Plz, Stamford, CT 06902-3602 | 2020-11-04 |
| 1972114619 | Danielle Young Yee | Registered Nurse | 1 Hospital Plz, Stamford, CT 06902-3602 | 2020-08-16 |
| 1104435767 | Alison Patricia O'connell | Nurse Practitioner | 1 Hospital Plz, Stamford, CT 06902-3602 | 2020-07-29 |
| 1245853787 | Nicole Sandilands | Nurse Practitioner | 1 Hospital Plz, Stamford, CT 06902-3602 | 2020-05-19 |
| 1376165704 | Kenny Ha | Pharmacist | 1 Hospital Plz, Stamford, CT 06902-3602 | 2020-05-07 |
| 1730708587 | Lauren Page | Student in an Organized Health Care Education/Training Program | 1 Hospital Plz, Stamford, CT 06902-3602 | 2020-04-13 |
| 1437788692 | Marie Sullivan | Student in an Organized Health Care Education/Training Program | 1 Hospital Plz, Stamford, CT 06902-3602 | 2020-04-08 |
| 1144859364 | Kristen Langan | Student in an Organized Health Care Education/Training Program | 1 Hospital Plz, Stamford, CT 06902-3602 | 2020-04-08 |
| 1104455369 | Brady Coad | Student in an Organized Health Care Education/Training Program | 1 Hospital Plz, Stamford, CT 06902-3602 | 2020-04-08 |
| 1235768839 | Victoria Kun Liang | Student in an Organized Health Care Education/Training Program | 1 Hospital Plz, Stamford, CT 06902-3602 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861043242 | Palak Bhambri | Pharmacist | 537 Canal Street, Stamford, CT 06902 | 2019-09-26 |
| 1730654815 | Brenice Duroseau | Nurse Practitioner | 292 Long Ridge Rd Ste 202, Stamford, CT 06902 | 2018-10-04 |
| 1447732862 | Ngoc Lam | Pharmacist | 1990 West Main Street, Stamford, CT 06902 | 2018-09-01 |
| 1336627264 | Margaret F Gorelick | Nurse Practitioner | Stamford Health, One Hospital Plaza, Stamford, CT 06902 | 2018-08-02 |
| 1174053425 | Ashley Marie Santana | Social Worker | 110 Commons Park N Apt 1158, Stamford, CT 06902 | 2017-06-19 |
| 1578090395 | Anas Al-sabbagh | Dentist | 1 Strawberry Hill Court Suite L7 Stamford, Connecticut, Stamford, CT 06902 | 2017-05-11 |
| 1154862936 | Hillary Rubin | Psychologist | 44 Commerce Avenue, Stamford, CT 06902 | 2017-03-14 |
| 1801332135 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1 Hospital Plz Ste G122, Stamford, CT 06902 | 2017-01-10 |
| 1932563277 | Mary Hurtadodemendoza | Pharmacist | 59 Courtland Ave 2m, Stamford, CT 06902 | 2016-04-13 |
| 1235592247 | Advanced Therapy and Performance LLC | Physical Medicine & Rehabilitation | 75 Selleck Street, Stamford, CT 06902 | 2016-03-29 |
| Find all providers in zip 06902 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992857072 | Daniel Jew | Physician Assistant | 30 Shelburne Rd., Stamford Hospital, Dept. of Cardiac Surgery, Stamford, CT 06904 | 2007-01-17 |
| 1407952195 | Melanie Dawn Rolla | Physician Assistant | 1418 Riverbank Rd, Stamford, CT 06903-2015 | 2006-09-16 |
| 1548254774 | Rebecca O'neill | Physician Assistant | 1177 Summer St, 5th Floor, Stamford, CT 06905-5572 | 2005-09-02 |
| 1790313021 | Corina Dasilva | Physician Assistant | 1 Hospital Plz, Stamford, CT 06902-3602 | 2020-03-31 |
| 1881235752 | Molly Stiles Arneth | Physician Assistant | 1 Hospital Plz, Stamford, CT 06902-3602 | 2019-10-02 |
| 1083188981 | Sean Vincent Rothenburger | Physician Assistant | 1 Hospital Plz, Stamford, CT 06902 | 2019-01-14 |
| 1659894772 | Jennifer Bellucci | Physician Assistant | 1 Hospital Plz, Stamford, CT 06902-3602 | 2017-07-20 |
| 1538609169 | Paul Anthony Buonocore | Physician Assistant | 32 Strawberry Hill Ct, 3rd Floor, Stamford, CT 06902-2594 | 2017-03-01 |
| 1922546514 | Maria De Vivo | Physician Assistant | 1 Hospital Plz, Stamford, CT 06902 | 2017-02-03 |
| 1558812966 | Ashley Lynn Henry | Physician Assistant | 1 Hospital Plz, Stamford, CT 06902 | 2016-10-20 |
| Find all providers in STAMFORD | ||||
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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.