DR. THOMAS E WALLACE III (NPI# 1316547342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316547342 |
| Entity Type | Individual |
| Full Name | DR. THOMAS E WALLACE III |
| Credential | PHARMD |
| Practice Address |
1571 Forest Ave Staten Island NY 10302-2226 |
| Mailing Address |
616 Bement Ave Staten Island NY 10310-2938 |
| Practice Telephone | 7187205604 |
| Mailing Telephone | 9179324257 |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PCT.0015303 | CT | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021696 | Thomas R Wallace | Ophthalmology | 211 Mcauley Ct, Hot Springs, AR 71913-6314 | 2005-05-27 |
| 1023499217 | Thomas Wallace | Massage Therapist | 17205 Vashon Hwy Sw, Suite B2, Vashon, WA 98070-4674 | 2015-06-12 |
| 1275945354 | Thomas Wallace Jr. | Counselor | 1646 S Court St, Visalia, CA 93277-4962 | 2014-05-23 |
| 1265787147 | Thomas Danville Wallace | Pharmacy Technician | 215 Dexter L Woods Memorial Blvd, Waynesboro, TN 38485-2416 | 2012-07-17 |
| 1386789147 | Thomas W Wallace | Psychiatry & Neurology | 180 Grand Ave Ste 100, Oakland, CA 94612-3766 | 2007-02-20 |
| 1801942933 | Thomas Clyde Wallace | Psychiatry & Neurology | 10 Congress St, Suite 360, Pasadena, CA 91105-3023 | 2007-01-25 |
| 1679641666 | Thomas M Wallace | Internal Medicine | 1441 Florida Ave, Modesto, CA 95350-4405 | 2006-11-30 |
| 1295807733 | Thomas Witherspoon Wallace | Internal Medicine | 10100 Kanis Rd, Little Rock, AR 72205-6202 | 2006-11-13 |
| 1639251416 | Thomas A Wallace | Social Worker | 254 N Washington St, Falls Church, VA 22046-4517 | 2006-10-20 |
| 1811089006 | Thomas K Wallace | Nurse Anesthetist, Certified Registered | 800 E 28th St, Minneapolis, MN 55407-3723 | 2006-09-28 |
| Street Address |
1571 FOREST AVE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10302-2226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134222961 | Cvs Albany LLC | Durable Medical Equipment & Medical Supplies | 1571 Forest Ave, Staten Island, NY 10302-2226 | 2006-09-07 |
| 1558869271 | Monika Cios | Pharmacist | 1571 Forest Ave, Staten Island, NY 10302-2226 | 2018-01-28 |
| 1760882443 | Anthony Justin Orlando | Pharmacist | 1571 Forest Ave, Staten Island, NY 10302-2226 | 2014-08-29 |
| 1891120374 | Lauren Elizabeth Calandra | Pharmacist | 1571 Forest Ave, Staten Island, NY 10302-2226 | 2013-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306494174 | Denasia Fitch | Student in an Organized Health Care Education/Training Program | 80 Willowbrook Rd, Staten Island, NY 10302 | 2019-08-26 |
| 1548752983 | Lawan Rickenbacker | Counselor | 28 Treadwell Ave, Staten Island, NY 10302 | 2018-06-01 |
| 1275059321 | Omolara Rachael Adediji | Nurse Practitioner | 210 Trantor Place, Apt 1d, Staten Island, NY 10302 | 2017-08-21 |
| 1558893479 | Joseph Wilson | Substance Abuse Rehabilitation Facility | 273 Heberton Avenue, Staten Island, NY 10302 | 2017-03-30 |
| 1902358864 | Natalie Valencia Toney-zubairu | Nurse Practitioner | Community Health Center of Richmond, 235 Port Richmond Ave, Staten Island, NY 10302 | 2016-10-26 |
| 1912453788 | Adewunmi Bankole | Registered Nurse | 124 Nicholas Avenue Apt B, Staten Island, NY 10302 | 2016-08-31 |
| 1154788974 | Eileen Patricia Cameron | Counselor | 263-267 Port Richmond Aveune, Staten Island, NY 10302 | 2016-01-25 |
| 1225468432 | Total Dental Care of Staten Island, P.C. | Dentist | 135 Willowbrook Road, Staten Island, NY 10302 | 2013-11-25 |
| 1760723621 | Si. Senior Lifestyle Center Inc | Clinic/Center | 98 Port Richmond Ave, Staten Island, NY 10302 | 2013-03-01 |
| 1962751255 | Kathleen Gomez-rodriguez | Speech-Language Pathologist | 12 Crystal Ave, Staten Island, NY 10302 | 2012-09-03 |
| Find all providers in zip 10302 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083220370 | Minamark M Nageib | Pharmacist | 72 Bridgetown St, Staten Island, NY 10314-6204 | 2020-09-22 |
| 1912513805 | Zakaria Amin | Pharmacist | 382 Ridgewood Ave, Staten Island, NY 10312-2118 | 2020-09-17 |
| 1073136065 | Matthew Thomas Tilatitsky | Pharmacist | 103 Sprague Ave, Staten Island, NY 10307-1931 | 2020-05-25 |
| 1255967220 | Peter J Delorenzo | Pharmacist | 123 Oxford Pl, Staten Island, NY 10301-3016 | 2020-03-21 |
| 1710525514 | Ira Bace | Pharmacist | 146 Freedom Ave, Staten Island, NY 10314-3706 | 2019-12-12 |
| 1760026983 | Hassan Gihad Hamouche | Pharmacist | 213 Norway Ave, Staten Island, NY 10305-3522 | 2019-10-30 |
| 1730722448 | Daniel Nabil Girgis | Pharmacist | 177 Sandalwood Dr, Staten Island, NY 10308-1863 | 2019-10-25 |
| 1437714300 | Miriam Lyubina | Pharmacist | 29 Star Ct, Staten Island, NY 10312-2448 | 2019-05-07 |
| 1134686173 | Muhammad Usman | Pharmacist | 928 Rockland Ave Apt 2, Staten Island, NY 10314-7706 | 2019-02-26 |
| 1831660786 | Amir I Yaqoob | Pharmacist | 92 Slater Blvd, Staten Island, NY 10305-2106 | 2018-12-17 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10302 |
Please comment or provide details below to improve the information on DR. THOMAS E WALLACE III.
| 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.