Healthcare Provider Details

I. General information

NPI: 1437643608
Provider Name (Legal Business Name): JOSHUA VALINSKY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 MAIN ST STE 122
MONROE CT
06468-2872
US

IV. Provider business mailing address

70 DEEPWOOD RD
EASTON CT
06612-1439
US

V. Phone/Fax

Practice location:
  • Phone: 203-261-7090
  • Fax: 888-856-3413
Mailing address:
  • Phone: 203-913-1787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number7885
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: