Michelle Wallace, PT is a
Physical Medicine & Rehabilitation - Pediatric Rehabilitation Medicine physician based in Tenafly, New Jersey. Michelle Wallace is licensed to practice in New Jersey (license number 40QA00591600) and her current practice location is 75 Norman Pl, Tenafly, New Jersey. She can be reached at her office (for appointments etc.) via phone at
(732) 761-0088.
NPI number for Michelle Wallace is 1477808947 and her current mailing address is 75 Norman Pl, Tenafly, New Jersey. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1477808947.
Physician's Profile
Full Name | Michelle Wallace |
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Gender | Female |
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Speciality | Physical Medicine & Rehabilitation - Pediatric Rehabilitation Medicine |
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Location | 75 Norman Pl, Tenafly, New Jersey |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1477808947
- Provider Enumeration Date: 07/19/2012
- Last Update Date: 07/19/2012
Medical Identifiers
Medical identifiers for Michelle Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1477808947 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2081P0010X | Physical Medicine & Rehabilitation - Pediatric Rehabilitation Medicine | 40QA00591600 (New Jersey) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Michelle Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Michelle Wallace, PT 75 Norman Pl, Tenafly, NJ 07670-2537 Ph: () - | Michelle Wallace, PT 75 Norman Pl, Tenafly, NJ 07670-2537 Ph: (732) 761-0088 |
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