Tracey Wallace in Canandaigua - Occupational Therapist
Tracey Wallace - NPI 1770638165
Tracey Wallace is a Occupational Therapist in Canandaigua, New York. Tracey Wallace practices all healthcare services and medical treatments related to Occupational Therapist. The NPI Number for Tracey Wallace is 1770638165. The last update date is 2014-01-22.
Tracey Wallace's current location address is 5415 N Bloomfield Rd, Canandaigua, New York. You can contact this provider via phone number 5853949510 and fax number 5853945326. The mailing address for Tracey Wallace is 5415 N Bloomfield Rd, Canandaigua, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tracey Wallace |
|---|---|
| Address | 5415 N Bloomfield Rd, Canandaigua, New York |
| Phone Number | 5853949510 |
| Fax Number | 5853945326 |
| Sole Proprietor | N |
| Credentials | OT |
NPI Number Detail
| NPI Number | 1770638165 |
|---|---|
| Provider Enumeration Date | 2007-01-24 |
| Last Updated Date | 2014-01-22 |
Provider Mailing Address Detail
| Address | 5415 N Bloomfield Rd |
|---|---|
| City | Canandaigua |
| State | New York (NY) |
| Post Code | 144247964 |
| Phone Number | 5853949510 |
| Fax Number | 5853945326 |
Provider's Primary Taxonomy Detail
| Speciality | Occupational Therapist |
|---|---|
| Taxonomy | 225X00000X |
| Licence No | 18323 |
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Definition: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federat |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 23389338 | NM | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Tracey Wallace by the Centers for Medicare & Medicaid Services?
The Tracey Wallace has been assigned the NPI (National Provider Identifier) 1770638165. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Tracey Wallace is located?
The Tracey Wallace is situated at the following address: 5415 N Bloomfield Rd, Canandaigua, NY, 144247964.
What is Tracey Wallace's specialized field of practice, and what is the corresponding taxonomy classification code?
The Tracey Wallace's area of specialization is Occupational Therapist, and the corresponding taxonomy code that categorizes this field of practice is 225X00000X.
On what date did the Tracey Wallace receive its 1770638165 assignment from the Centers for Medicare & Medicaid Services?
The Tracey Wallace was assigned its 1770638165 by the Centers for Medicare & Medicaid Services on 2007-01-24.
As of what date were the Tracey Wallace's details last updated?
The information pertaining to the Tracey Wallace, including its address, specialty, and other details, was most recently updated on 2014-01-22.