Wallace, Kyle

Wallace, Kyle is an sole proprietor health care provider with primary practice located at 20870 Grand Central Pkwy Apt 3G , Queens Village NY 11427-1559. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is his primary health care specialty. Wallace, Kyle can be contacted via phone (646) 533-2645.

Contact Information

Primary practice address
20870 Grand Central Pkwy Apt 3G Queens Village NY 11427-1559
Phone: (646) 533-2645
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 546269-1 New York
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X F311097-01 New York

Profile Details

NPI number 1205258258
LBN Legal business name Wallace, Kyle
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 10th, 2014
Last updated Jul 19th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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