Healthcare Provider Details

I. General information

NPI: 1881727154
Provider Name (Legal Business Name): VALLEY MEDICAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 12/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 DIVISION ST
ANSONIA CT
06401-2134
US

IV. Provider business mailing address

135 DIVISION ST
ANSONIA CT
06401-2134
US

V. Phone/Fax

Practice location:
  • Phone: 203-735-9354
  • Fax: 203-732-2106
Mailing address:
  • Phone: 203-735-9354
  • Fax: 203-732-2106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number016432
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number028004
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number020100
License Number StateCT

VIII. Authorized Official

Name: DR. STEPHEN J MOSES
Title or Position: VICE-PRESIDENT
Credential: M.D.
Phone: 203-735-9354