1366838419 NPI number — VALINS NURSE PRACTITIONER PSYCHIATRY, PLLC

Table of content: (NPI 1366838419)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366838419 NPI number — VALINS NURSE PRACTITIONER PSYCHIATRY, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALINS NURSE PRACTITIONER PSYCHIATRY, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JULIE VALINS, NPP
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366838419
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
29 ELIZABETH DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHPAGE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11714-6022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-459-6639
Provider Business Mailing Address Fax Number:
516-224-3799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29 ELIZABETH DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHPAGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11714-6022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-459-6639
Provider Business Practice Location Address Fax Number:
516-224-3799
Provider Enumeration Date:
04/15/2015

Additional Information

Authorized Official

Authorized Official Last Name:
PERSAUD
Authorized Official First Name:
ANNE
Authorized Official Middle Name:
T
Authorized Official Title or Position:
BILLER
Authorized Official Telephone Number:
631-399-9859

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  F400558 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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