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Stacey Wallace
NPI 1700149838 · Specialist · Fredonia, NY
Stacey Wallace is a Specialist provider in Fredonia, NY (NPI 1700149838).
Provider details
- NPI number
- 1700149838
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 374992091 (NY)
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 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
75 Chestnut St
Fredonia, NY 14063-1630
Phone: (716) 672-2731
Street-level locationGet directions
Mailing address
Po Box 311
Fredonia, NY 14063-0311
Registry dates
- Enumerated
- 2012-06-22
- Last updated
- 2012-06-22
Frequently asked questions
- What is Stacey Wallace's NPI number?
- Stacey Wallace's National Provider Identifier (NPI) is 1700149838, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Stacey Wallace's specialty?
- Stacey Wallace is listed in the NPPES registry with a primary specialty of Specialist (Other Service Providers).
- Where is Stacey Wallace located?
- Stacey Wallace's practice location on file with NPPES is 75 Chestnut St, Fredonia, NY 14063-1630.
- What is Stacey Wallace's phone number?
- The practice phone number listed in the NPPES registry for Stacey Wallace is (716) 672-2731.
- Is Stacey Wallace's NPI active?
- Yes — Stacey Wallace's NPI (1700149838) is active in the NPPES registry as of the last update on 2012-06-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.