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DR. WALLACE LLERA M.D.
NPI 1013990332
Family Medicine - Adult Medicine in Philadelphia, PA

Active since November 21, 2005
401-55 W ALLEGHENY AVE, PHILADELPHIA, PA 19133(215) 291-2500(215) 291-2587 Get Directions Write a Review

NPPES record last updated: June 7, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Wallace Llera M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WALLACE LLERA M.D. (NPI 1013990332) is an individual adult medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD038236L) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1013990332
Entity TypeIndividualMale
Primary Taxonomy207QA0505X
Provider Legal NameDR. WALLACE LLERACredential: M.D.
Location Address401-55 W ALLEGHENY AVEPhiladelphia, PA 19133-3644
Mailing Address1412 Fairmount AvePhiladelphia, PA 19130-2908 · (215) 599-4851 · Fax (215) 232-4093
Phone(215) 291-2500
Fax(215) 291-2587
Sole ProprietorNo
Enumeration DateNovember 21, 2005
Last NPPES UpdateJune 7, 2011
✔ NPI 1013990332 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in PA · MD038236L
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
401-55 W ALLEGHENY AVE, Philadelphia, PA 19133
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Other Identifiers 2

Medicare ID-Type UnspecifiedLL155828PA
Medicaid001019428 - 0022PA

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DELAWARE VALLEY COMMUNITY HEALTH, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
401-55 W ALLEGHENY AVE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500
DR. IRISAIDA MARTINEZ M.D.
Pediatrics
401-55 W ALLEGHENY AVE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500
DR. ASSEM ABDEL-KADER DDS
Dentist
401-55 W ALLEGHENY AVE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500
DR. MICHELLE J HUDSON DDS
Dentist
401-55 W ALLEGHENY AVE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500
ELANA LEVITES-AGABABA
Pediatrics
401-55 W ALLEGHENY AVE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500
DELAWARE VALLEY COMMUNITY HEALTH INC
Specialist
401-55 W ALLEGHENY AVE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500
DR. CARMEN FEBO-SAN MIGUEL M.D.
Family Medicine (Adult Medicine)
401-55 W ALLEGHENY AVE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wallace Llera's NPI number?

The NPI number for Wallace Llera is 1013990332. It was assigned to this individual provider in the NPPES registry on November 21, 2005.

Where is Wallace Llera located?

Wallace Llera practices at 401-55 W Allegheny Ave, Philadelphia, PA 19133. The listed phone number is (215) 291-2500.

What is Wallace Llera's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Wallace Llera was last updated on June 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.