Kyana Y Wallace (NPI# 1558611483, PAC ID# 1355579327) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1558611483 |
| PAC ID by PECOS | 1355579327 |
| Professional Enrollment ID | I20140121000799 |
| Full Name | Kyana Y Wallace |
| Organization Legal Name | NORTH SHORE LIJ URGENT CARE PC |
| Address |
67 Shore Rd Port Washington NY 11050-2227 |
| Phone Number | 5162532890 |
| Gender | F |
| Graduation Year | 2012 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 6002131778 |
| Number of Group Practice Members | 156 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 71 Forest Ave, Glen Cove, NY 11542-2112 | 3474932941 | NORTH SHORE LIJ URGENT CARE PC |
| 377 S Oyster Bay Rd, Plainview, NY 11803-3323 | 5165379061 | NORTH SHORE LIJ URGENT CARE PC |
| 67 Shore Rd, Port Washington, NY 11050-2227 | 5162532890 | NORTH SHORE LIJ URGENT CARE PC |
| 1033 Northern Blvd, Roslyn, NY 11576-1502 | 5165379063 | NORTH SHORE LIJ URGENT CARE PC |
| Organization Legal Name | NORTH SHORE LIJ URGENT CARE PC |
| Physicians | 164 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Tabi | Family Medicine | North Shore Lij Urgent Care PC | 77 Quaker Ridge Rd, Suite 4, New Rochelle, NY 10804-2812 |
| Sunitha Korapati | Emergency Medicine | North Shore Lij Urgent Care PC | 30 Livingston Ave, Dobbs Ferry, NY 10522-2815 |
| Brent Wood Matza | Emergency Medicine | North Shore Lij Urgent Care PC | 176 3rd Ave, New York, NY 10003-2520 |
| Ellyse Cipriano | Physician Assistant | North Shore Lij Urgent Care PC | 603 E Main St, B, Bay Shore, NY 11706-8505 |
| Kaitlyn Krause | Physician Assistant | North Shore Lij Urgent Care PC | 5171-a Sunrise Hwy, Bohemia, NY 11716-4615 |
| Michael Green | Family Medicine | North Shore Lij Urgent Care PC | 655 White Plains Rd, Tarrytown, NY 10591-5105 |
| Dina M Rivera | Physician Assistant | North Shore Lij Urgent Care PC | 19 W Jericho Tpke, Huntington Station, NY 11746-3601 |
| Dennis Zaide | Internal Medicine | North Shore Lij Urgent Care PC | 199 Amsterdam Ave, New York, NY 10023-5024 |
| Luciano R Loseto | Physician Assistant | North Shore Lij Urgent Care PC | 595 Hempstead Tpke, Suite A, West Hempstead, NY 11552-1030 |
| Stephanie A Mercer | Physician Assistant | North Shore Lij Urgent Care PC | 1912 Jericho Tpke, East Northport, NY 11731-6207 |
| Street Address |
67 SHORE RD |
| City | PORT WASHINGTON |
| State | NY |
| Zip | 11050-2227 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jose T. Vargas | Physician Assistant | North Shore Lij Urgent Care PC | 67 Shore Rd, Port Washington, NY 11050-2227 |
| Tsehwa Yao | Physician Assistant | North Shore Lij Urgent Care PC | 67 Shore Rd, Port Washington, NY 11050-2227 |
| Andres M Melo | Physician Assistant | North Shore Lij Urgent Care PC | 67 Shore Rd, Port Washington, NY 11050-2227 |
| Allison M Tiberio | Physician Assistant | North Shore-lij Urgent Care, PC | 67 Shore Rd, Port Washington, NY 11050-2227 |
| Nicole M Campbell | Physician Assistant | North Shore-lij Urgent Care, PC | 67 Shore Rd, Port Washington, NY 11050-2227 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William M Levine | Podiatry | 17 Woodland Dr, Port Washington, NY 11050-1136 | |
| Zelik Ziegelbaum | Physical Therapy | 26 Manorhaven Blvd, Port Washington, NY 11050-1608 | |
| Zulmary Andino | Physical Therapy | 45 Dunwood Rd, Port Washington, NY 11050-1635 | |
| Robbin Gatta | Clinical Social Worker | 3 Seaview Ln, Port Washington, NY 11050-1737 | |
| Susan M Bagnini | Clinical Social Worker | 100 Oakland Ave, Port Washington, NY 11050-1842 | |
| Dennis J Kinneary | Physical Therapy | 45 Channel Dr, Port Washington, NY 11050-2216 | |
| Jagmohan S Walia | Optometry | 25 Old Shore Rd, Port Washington, NY 11050-2222 | |
| Michael D Leibowitz | Physical Medicine and Rehabilitation | 1440 Port Washington Blvd, Port Washington, NY 11050-2412 | |
| Janice M Wise | Clinical Social Worker | 94 Pond View Dr, Port Washington, NY 11050-2454 | |
| Myles E Gombert | Internal Medicine | Myles E Gombert Md PC | 30 Wood Rd, Sands Point, NY 11050-2625 |
| Find all physicians in zip 11050 | |||
| City | PORT WASHINGTON |
| Zip Code | 11050 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | PORT WASHINGTON + PHYSICIAN ASSISTANT |
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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.