Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Marc Kenneth Wallack, MD

Individual provider Surgical Oncology Physician · NPI 1679650683

Dr. Marc Kenneth Wallack, MD is a General Surgery in New York, New York. Graduated from University of Pittsburgh School of Medicine in 1970, 56 years ago. Practices with Physician Affiliate Group of New York PC, a 1,224-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
56
Trained at
University of Pittsburgh School of Medicine
Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1901 1st Ave Rm 12A1
New York, NY 10029-7404
Phone: (212) 423-6614
Fax: (212) 423-7913
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Oncology Physician (primary) Taxonomy 2086X0206X · Licence 185118 (NY)

Record details

NPI number1679650683
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedNovember 1, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
Graduated 1970 (56 years in practice)
Group practice Physician Affiliate Group Of New York Pc — 1224 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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