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

Shannon Wallace

Individual provider Specialist · NPI 1588142574

Shannon Wallace is a Specialist in Bellerose, New York. Registered with an NPI since 2018.

In the registry since
2018
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Practice location Address checks out

8777 254th St
Bellerose, NY 11426-2329
Phone: (347) 324-2766
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1588142574
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 1, 2018
Last updated in NPPESSeptember 13, 2018
Mailing address8777 254th St, Bellerose, NY 11426-2329

Other providers in Bellerose