Wallace Llera in Philadelphia - Adult Medicine
Wallace Llera - NPI 1013990332
Wallace Llera is a Adult Medicine in Philadelphia, Pennsylvania. Wallace Llera practices all healthcare services and medical treatments related to Adult Medicine. The NPI Number for Wallace Llera is 1013990332. The last update date is 2011-06-07.
Wallace Llera's current location address is 1412 Fairmount Ave, Philadelphia, Pennsylvania. You can contact this provider via phone number 2155994851 and fax number 2152324093. The mailing address for Wallace Llera is 1412 Fairmount Ave, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Wallace Llera |
|---|---|
| Address | 1412 Fairmount Ave, Philadelphia, Pennsylvania |
| Phone Number | 2155994851 |
| Fax Number | 2152324093 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1013990332 |
|---|---|
| Provider Enumeration Date | 2005-11-21 |
| Last Updated Date | 2011-06-07 |
Provider Mailing Address Detail
| Address | 1412 Fairmount Ave |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 191302908 |
| Phone Number | 2155994851 |
| Fax Number | 2152324093 |
Provider's Primary Taxonomy Detail
| Speciality | Adult Medicine |
|---|---|
| Taxonomy | 207Qa0505X |
| Licence No | MD038236L |
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Definition: The NUCC recommends this code not be used. Choose a more appropriate code. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 001019428 - 002 | PA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Wallace Llera by the Centers for Medicare & Medicaid Services?
The Wallace Llera has been issued the NPI (National Provider Identifier) 1013990332 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Wallace Llera located?
The Wallace Llera is located at 1412 Fairmount Ave, Philadelphia, PA 191302908.
What is Wallace Llera's specialized field of practice, and what is the corresponding taxonomy classification code?
The Wallace Llera's area of specialization is Adult Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Qa0505X.
On what date did Wallace Llera receive its 1013990332 assignment from the Centers for Medicare & Medicaid Services?
The Wallace Llera was assigned its 1013990332 on 2005-11-21, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Wallace Llera, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Wallace Llera, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2011-06-07.
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