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

MS. Stacey Marie Wallace

Individual provider Specialist · NPI 1700149838

MS. Stacey Marie Wallace is a Specialist in Fredonia, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2012
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Practice location Address checks out

75 Chestnut St
Fredonia, NY 14063-1630
Phone: (716) 672-2731
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 374992091 (NY)

Record details

NPI number1700149838
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 22, 2012
Last updated in NPPESJune 22, 2012

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