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

Fabiola Corbette Wallace, MD

Individual provider Family Medicine Physician · NPI 1932847282

Fabiola Corbette Wallace, MD is a Family Practice in New York, New York. Qualified in 2017, 9 years ago. Works from 2 locations. Licensed in New York.

Years since qualifying
9
Licensed in
NY
In the registry since
2022
Specialties on file
2
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

1790 Broadway Ste 1802
New York, NY 10019-1471
Phone: (212) 530-0624
Fax: (415) 252-7176
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Family Practice Dr, Kingston, NY 12401-6449 — (845) 338-6400

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 338132 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1932847282
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 26, 2022
Last updated in NPPESNovember 7, 2025
Certification dateNovember 7, 2025

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated

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