Ms La' Taysia Wallace, MSN, RN, CPNP-PC - Nurse Practitioner in Huntington Station, NY

Ms La' Taysia Wallace, MSN, RN, CPNP-PC is a Nurse Practitioner - Pediatrics based in Huntington Station, New York. Ms La' Taysia Wallace is licensed to practice in New York (license number F383676-01) and her current practice location is 21 Penny Dr, Huntington Station, New York. She can be reached at her office (for appointments etc.) via phone at (516) 850-9623.

NPI number for Ms La' Taysia Wallace is 1114297074 and her current mailing address is Po Box 3644, Mount Vernon, New York. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1114297074.

Contact Information

Ms La' Taysia Wallace, MSN, RN, CPNP-PC
21 Penny Dr,
Huntington Station, NY 11746-3422
(516) 850-9623
Not Available

Map and Direction




Provider's Profile

Full NameMs La' Taysia Wallace
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location21 Penny Dr, Huntington Station, New York
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1114297074
  • Provider Enumeration Date: 01/10/2012
  • Last Update Date: 04/02/2024

Medical Identifiers

Medical identifiers for Ms La' Taysia Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114297074NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 716807-1 (New York)Secondary
164W00000XLicensed Practical Nurse 308886-1 (New York)Secondary
363LP0200XNurse Practitioner - Pediatrics F383676-01 (New York)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. Ms La' Taysia 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 AddressPractice Location Address
Ms La' Taysia Wallace, MSN, RN, CPNP-PC
Po Box 3644,
Mount Vernon, NY 10553-3644

Ph: (516) 850-9623
Ms La' Taysia Wallace, MSN, RN, CPNP-PC
21 Penny Dr,
Huntington Station, NY 11746-3422

Ph: (516) 850-9623

Reviews and Comments


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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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