IndividualActive
Mavern Wallace
NPI 1902166614 · Registered Nurse · Valley Stream, NY
Mavern Wallace is a Registered Nurse provider in Valley Stream, NY (NPI 1902166614).
Provider details
- NPI number
- 1902166614
- Entity type
- Individual
- Primary specialty
- Registered NurseNursing Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 584436 (NY)
Specialties & taxonomies
Nursing 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
13 Cleveland St
Valley Stream, NY 11580-6003
Phone: (516) 823-0739
Street-level locationGet directions
Mailing address
103 E Carpenter St
Valley Stream, NY 11580-4419
Registry dates
- Enumerated
- 2012-05-29
- Last updated
- 2012-05-29
Frequently asked questions
- What is Mavern Wallace's NPI number?
- Mavern Wallace's National Provider Identifier (NPI) is 1902166614, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mavern Wallace's specialty?
- Mavern Wallace is listed in the NPPES registry with a primary specialty of Registered Nurse (Nursing Service Providers).
- Where is Mavern Wallace located?
- Mavern Wallace's practice location on file with NPPES is 13 Cleveland St, Valley Stream, NY 11580-6003.
- What is Mavern Wallace's phone number?
- The practice phone number listed in the NPPES registry for Mavern Wallace is (516) 823-0739.
- Is Mavern Wallace's NPI active?
- Yes — Mavern Wallace's NPI (1902166614) is active in the NPPES registry as of the last update on 2012-05-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.