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KEVIN GARY WALLACE PHARMD.
NPI 1144576919
Pharmacist in Staten Island, NY

Active since July 31, 2012
94 LADD AVE, STATEN ISLAND, NY 10312(917) 270-4362 Get Directions Write a Review

NPPES record last updated: July 31, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kevin Gary Wallace Pharmd. NPPES

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

KEVIN GARY WALLACE PHARMD. (NPI 1144576919) is an individual pharmacist in Staten Island, New York, licensed in New York (057064) and active in the NPI registry since July 2012.

NPPES Registry Identity

NPI1144576919
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameKEVIN GARY WALLACECredential: PHARMD.
Location Address94 LADD AVEStaten Island, NY 10312-1515
Mailing Address94 Ladd AveStaten Island, NY 10312-1515 · (917) 270-4362
Phone(917) 270-4362
Sole ProprietorYes
Enumeration DateJuly 31, 2012
✔ NPI 1144576919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in NY · 057064
Definition
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.
94 LADD AVE, Staten Island, NY 10312
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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 Kevin Wallace's NPI number?

The NPI number for Kevin Wallace is 1144576919. It was assigned to this individual provider in the NPPES registry on July 31, 2012.

Where is Kevin Wallace located?

Kevin Wallace practices at 94 Ladd Ave, Staten Island, NY 10312. The listed phone number is (917) 270-4362.

What is Kevin Wallace's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Kevin Wallace was last updated on July 31, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.