EMMA WALLACE MD/PHD NPI 1558893503

NPI Information

NPI: 1558893503
Provider Name: EMMA WALLACE, MD/PHD
Classification: Psychiatry & Neurology - 2084V0102X
Specialization: Vascular Neurology
Entity Type: Individual
PECOS Registration: Yes
Address: 111 E 210TH ST
BRONX, NY
ZIP 10467
Phone: (718) 430-3166

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NPI Details

Emma Wallace, MD/PHD is a vascular neurology psychiatry neurology in Bronx, NY with 9 years of experience. The provider is vascular Neurology is a subspecialty in the evaluation, prevention, treatment and recovery from vascular diseases of the nervous system. This subspecialty includes the diagnosis and treatment of vascular events of arterial or venous origin from a large number of causes that affect the brain or spinal cord such as ischemic stroke, intracranial hemorrhage, spinal cord ischemia and spinal cord hemorrhage. Emma Wallace, MD/PHD NPI is 1558893503. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Graduation Year:2017

The provider's business location address is:

111 E 210TH ST
BRONX, NY
ZIP 10467-401
Phone: (718) 430-3166

The NPI 1558893503 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/29/2017 and was last updated on 4/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0204X	Radiology	Vascular & Interventional Radiology	312463	NEW YORK	No
2	390200000X	Student in an Organized Health Care Education/Training Program				No
3	2084V0102X	Psychiatry & Neurology	Vascular Neurology	312463	NEW YORK	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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