Provider Demographics
NPI:1174625545
Name:MERES, WALLACE P (AUD)
Entity type:Individual
Prefix:DR
First Name:WALLACE
Middle Name:P
Last Name:MERES
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 EAST RD
Mailing Address - Street 2:
Mailing Address - City:WALLKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12589
Mailing Address - Country:US
Mailing Address - Phone:845-838-5226
Mailing Address - Fax:845-838-5266
Practice Address - Street 1:V A HUDSON VALLEY HEALTH CARE SYSTEM
Practice Address - Street 2:ALBANY POST ROAD
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548
Practice Address - Country:US
Practice Address - Phone:845-838-5226
Practice Address - Fax:845-838-5266
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001614-1231H00000X
VA2201000569231H00000X
NY14000007194237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist