Larry B Wallace (NPI# 1073545059, PAC ID# 0547440760) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1073545059 |
| PAC ID by PECOS | 0547440760 |
| Professional Enrollment ID | I20110204000797 |
| Full Name | Larry B Wallace |
| Address |
322 N Aurora St Ithaca NY 14850-4202 |
| Phone Number | 6072774749 |
| Gender | M |
| Medical School | NEW ENGLAND COLLEGE OF OPTOMETRY |
| Graduation Year | 1973 |
| Primary Specialty | OPTOMETRY |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 322 N Aurora St, Ithaca, NY 14850-4202 | 6072774749 | |
| 322 N Aurora St, Ithaca, NY 14850-4202 | WHOLE PICTURE HEALTH AND VISION LLC |
| Street Address |
322 N AURORA ST |
| City | ITHACA |
| State | NY |
| Zip | 14850-4202 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tanya S Bloom | Optometry | Whole Picture Health and Vision LLC | 322 N Aurora St, Ithaca, NY 14850-4202 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Victoria Anne Vargas | Clinical Social Worker | Dewitt Mall 215 N Cayuga St, Suite 77, Ithaca, NY 14850 | |
| Ashlin M Thuman | Nurse Practitioner | Cayuga Medical Associates PC | 2432 N Triphammer Rd, Ithaca, NY 14850-1014 |
| Brian S Marino | Cardiovascular Disease (cardiology) | Cayuga Medical Associates PC | 2432 N Triphammer Rd, Ithaca, NY 14850-1014 |
| Sara Schewel Foster | Nurse Practitioner | Cayuga Medical Associates PC | 2432 N Triphammer Rd, Ithaca, NY 14850-1014 |
| Paula Fitzsimmons | Physician Assistant | Cayuga Medical Associates PC | 1020 Craft Rd, Ithaca, NY 14850-1016 |
| Diana M Stephens | Dermatology | Cayuga Medical Associates PC | 1020 Craft Rd, Ithaca, NY 14850-1016 |
| Marie A Harkins | Nurse Practitioner | Cayuga Medical Associates PC | 1020 Craft Rd, Suite C, Ithaca, NY 14850-1016 |
| Lori Davis | Nurse Practitioner | Cayuga Medical Associates PC | 1020 Craft Rd, Ithaca, NY 14850-1016 |
| Alexandra T Burch | Nurse Practitioner | Cayuga Medical Associates PC | 1020 Craft Rd, Ithaca, NY 14850-1016 |
| Brad A Yentzer | Dermatology | Cayuga Medical Associates PC | 1020 Craft Rd, Ithaca, NY 14850-1016 |
| Find all physicians in zip 14850 | |||
| City | ITHACA |
| Zip Code | 14850 |
| Specialty | OPTOMETRY |
| City + Specialty | ITHACA + OPTOMETRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.