Kevin Gary Wallace
Pharmacist
94 Ladd Ave, Staten Island
New York, 10312-1515
917-270-4362 Kevin Gary Wallace is a pharmacist in Staten Island, New York. Patients can reach him at 94 Ladd Ave, Staten Island or contact him on 917-270-4362. Active license number of Kevin Gary Wallace is 057064 for Pharmacist in New York.
Kevin Gary Wallace is an individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
Complete Profile:
Kevin Gary Wallace speciality, credentials, practice address, contact phone number and fax are as below. Patients can call on the below given phone number for enquiries.
| Name: | Kevin Gary Wallace |
| Specialization: | Pharmacist |
| Credentials: | PHARMD. |
| Gender: | Male |
| Location: | 94 Ladd Ave, Staten Island,
New York, 10312-1515 |
| Phone: | 917-270-4362 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of Kevin Gary Wallace are as mentioned below.
| NPI Number: | 1144576919 |
| NPI Enumeration Date: | 31 Jul, 2012 |
| NPI Last Update On: | 31 Jul, 2012 |
Medical Licenses:
Pharmacists can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kevin Gary Wallace are as mentioned below.
| Specialization | License Number | State | Status | |
| Pharmacist | 057064 | New York | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 94 Ladd Ave,
Staten Island, New York |
| Zip: | 10312-1515 |
| Phone Number: | 917-270-4362 |
Patients can reach Kevin Gary Wallace at
94 Ladd Ave, Staten Island, New York or can
call on phone at 917-270-4362.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.