OrganizationActive
Wallace Vascular, LLC.
NPI 1629796941 · Vascular Surgery Physician · Cranberry Township, PA
Provider details
- NPI number
- 1629796941
- Entity type
- Organization
- Primary specialty
- Vascular Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Justin Wallace, Medical Doctor(724) 201-2399
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
51 Dutilh Rd Ste 100
Cranberry Township, PA 16066-4148
Phone: (724) 201-2399
Fax: (724) 776-3864
Street-level locationGet directions
Mailing address
51 Dutilh Rd Ste 100
Cranberry Township, PA 16066-4148
Registry dates
- Enumerated
- 2022-08-22
- Last updated
- 2022-08-22
- Certified
- 2022-08-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.