Stephanie Wallace, NEMT
Transportation Network Company in Esopus, NY. Individual provider (NPI-1).
NPI number1558091983
StatusActive
Last updated in NPPESJun 17, 2022
Details
- NPI
- 1558091983
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Stephanie Wallace
- Credential
- NEMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 17, 2022
- Certification date
- Jun 16, 2022
- Last updated
- Jun 17, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 342000000X | Transportation Network Company | – | – | Yes |
Practice location
60 Main St # 61Esopus, NY 12429-9800
Phone 845-901-9966
Mailing address
Po Box 61Esopus, NY 12429-0061
Phone 845-901-9966
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