Healthcare Provider Details

I. General information

NPI: 1760771083
Provider Name (Legal Business Name): PAMELA VALENZA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 06/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5075 LINCOLN ST
DENVER CO
80216
US

IV. Provider business mailing address

5075 LINCOLN ST
DENVER CO
80216-2015
US

V. Phone/Fax

Practice location:
  • Phone: 720-274-2923
  • Fax: 303-433-7452
Mailing address:
  • Phone: 720-274-2940
  • Fax: 303-583-0152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA09549800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: