DR. AFRICA F. WALLACE (NPI# 1548279706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548279706 |
| Entity Type | Individual |
| Full Name | DR. AFRICA F. WALLACE |
| Credential | MD |
| Practice Address |
2 Capital Way Ste 356 Pennington NJ 08534-2521 |
| Practice Telephone | 6095376000 |
| Practice Fax Number | 6095376002 |
| Mailing Telephone | 6098157829 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2019-09-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | MD427591 | PA | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | MD427591 | PA | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 25MA10677300 | NJ | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 070603 | GA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 95 Collier Rd Nw, Suite 2055, Atlanta, GA 303091796 | 4046055699 | 4043554235 |
| Street Address |
2 CAPITAL WAY STE 356 |
| City | PENNINGTON |
| State | NJ |
| Zip Code | 08534-2521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255357877 | Cataldo Doria | Surgery | 2 Capital Way Ste 356, Pennington, NJ 08534 | 2006-07-15 |
| 1235767674 | Elizabeth George | Dietitian, Registered | 2 Capital Way Ste 356, Pennington, NJ 08534-2521 | 2020-03-31 |
| 1255965265 | Taryn Whitehead | Registered Nurse | 2 Capital Way Ste 356, Pennington, NJ 08534-2521 | 2020-02-28 |
| 1477019701 | Theresa Balestrieri | Dietitian, Registered | 2 Capital Way Ste 356, Pennington, NJ 08534-2521 | 2019-02-12 |
| 1649740945 | Amanda Gonzalez | Nurse Practitioner | 2 Capital Way Ste 356, Pennington, NJ 08534-2521 | 2018-11-29 |
| 1508352048 | Jillian Patricia Walsh | Surgery | 2 Capital Way Ste 356, Pennington, NJ 08534-2521 | 2018-07-09 |
| 1902306434 | Samantha Eckardt | Dietitian, Registered | 2 Capital Way Ste 356, Pennington, NJ 08534-2521 | 2018-02-21 |
| 1841558079 | Ashlee Nicole Godshalk Ruggles | Surgery | 2 Capital Way Ste 356, Pennington, NJ 08534-2521 | 2012-04-25 |
| 1366731671 | Christine Lotto | Surgery | 2 Capital Way Ste 356, Pennington, NJ 08534-2521 | 2011-04-07 |
| 1124141304 | Monika Wyganowska Mansmann | Physician Assistant | 2 Capital Way Ste 356, Pennington, NJ 08534-2521 | 2007-04-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871105163 | Arielle Skoryk | Psychologist | 800 Denow Road, Suite C #337, Pennington, NJ 08534 | 2020-08-19 |
| 1033751904 | Theresa Marie Archer | Registered Nurse | 108 Straube Center Blvd Suite I-17, Pennington, NJ 08534 | 2019-10-12 |
| 1295216059 | Confidentialistener LLC | Psychologist | 106 Straube Ctr Blvd Ste F112, Pennington, NJ 08534 | 2018-08-28 |
| 1245722164 | Jeffrey Adam Fehder | Nurse Anesthetist, Certified Registered | Capital Health Medical Center - Hopewell, 1 Capital Way - Second Floor, Anesthesia Offices, Pennington, NJ 08534 | 2018-06-06 |
| 1942711650 | Robert Vincent Simone | Social Worker | 65 South Main Street, Bldg. B Suite B-103, Pennington, NJ 08534 | 2017-10-20 |
| 1568980266 | Oaks Integrated Care | Clinic/Center | 720 Heritage Ct, Pennington, NJ 08534 | 2017-09-01 |
| 1326573601 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 103 Heritage Court, Pennington, NJ 08534 | 2017-04-25 |
| 1891220174 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 104 Heritage Court, Pennington, NJ 08534 | 2017-04-25 |
| 1124553409 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 105 Heritage Court, Pennington, NJ 08534 | 2017-04-25 |
| 1215486147 | Janine Disanti | Optometrist | Two Capital Way, Suite 326, Matossian Eye Associates, Pennington, NJ 08534 | 2016-10-04 |
| Find all providers in zip 08534 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073057543 | Mohamed Abbassi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 91 Goodwin Dr, North Brunswick, NJ 08902-4273 | 2016-12-18 |
| 1578975520 | Kennedy Medical Group Practice, P.C. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 485 Williamstown Road, Sicklerville, NJ 08081 | 2014-05-27 |
| 1770913782 | Advanced Cardiovascular Specialists LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 12 Brown Ct, Livingston, NJ 07039-1520 | 2013-11-13 |
| 1346687647 | Leonid Emerel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 54 Mccampbell Rd, Holmdel, NJ 07733-2229 | 2013-05-28 |
| 1477899607 | Hudson Cardiothoracic Surgery, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4 Bucks Mill Ln, Holmdel, NJ 07733-1756 | 2012-12-16 |
| 1801194659 | Mamsurg Thoracic Surgery LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4013 Us Highway 9, Howell, NJ 07731-4021 | 2011-03-03 |
| 1538472873 | Ronald E Ross | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 200 Trenton Rd - Deborah Heart & Lung Center, Mid Atlantic Surgical Associates, Browns Mills, NJ 08015 | 2010-07-15 |
| 1962727644 | Benjamin Van Boxtel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Mid-atlantic Surgical Associates, 100 Madison Avenue, Morristown, NJ 07960 | 2010-04-06 |
| 1699003145 | Douglas Joseph Dipaola | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5 Fullerton Rd, Moorestown, NJ 08057-1926 | 2009-11-20 |
| 1770810749 | James Clark Hart | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 37 Hurlingham Club Rd, Far Hills, NJ 07931-2479 | 2009-11-11 |
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| City | PENNINGTON |
| Zip Code | 08534 |
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| 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.