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Dr. Wallace Llera, MD
Adult Medicine Physician in Philadelphia, Pennsylvania
NPI 1013990332

Wallace Llera is an Adult Medicine Physician based in Philadelphia, PA and is specialized in Adult Medicine. Wallace Llera practices in Philadelphia, PA and has the professional credentials of MD. The NPI Number for Wallace Llera is 1013990332 and holds a License No. MD038236L (Pennsylvania).

The current practice location address for Wallace Llera is 401-55 W Allegheny Ave, Philadelphia, PA and can be reached out via phone at 215-291-2500 and via fax at 215-291-2587. You can also correspond with Wallace Llera through the mailing address at 1412 FAIRMOUNT AVE, PHILADELPHIA, PA - 19130-2908 (mailing address contact number: 215-599-4851).

Location: 401-55 W Allegheny Ave, Philadelphia, PA, 19130-2908
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Provider Profile Details
NPI Number
1013990332
Provider Name
Wallace Llera
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
401-55 W Allegheny Ave, Philadelphia, PA, 19130-2908
Phone Number
215-291-2500
Fax Number
215-291-2587
Provider Enumeration Date
11/21/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
001019428 - 0022 05 PA
institution
Provider Business Practice Location Address Details
Address
401-55 W Allegheny Ave
City
State
Zip
19133-3644
Phone Number
215-291-2500
Fax Number
215-291-2587
person
Provider Business Mailing Address Details
Address
1412 Fairmount Ave
City
State
Zip
19130-2908
Phone Number
215-599-4851
Fax Number
215-232-4093
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
License No.
MD038236L (Pennsylvania)
Definition
Definition to come.
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