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Contact Information

EVELYN ADDO WALLACE, NP
165 BROADWAY FL 23
NEW YORK, NY10006-1452
 Phone: 888-731-8994
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Women's Health

363LW0102X 50 Nurse Practitioner
 

Women's Health Care, Ambulatory

163WW0101X
Indicates primary specialty

NPI Profile & details for EVELYN ADDO WALLACE · (Female)

NPI Number 1184965493
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 03/12/2013
Last updated 10/01/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • NY License # 659682-1
  • NY License # F421131-1
  • NY Medicaid 00695941
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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