Healthcare Provider Details

I. General information

NPI: 1033852009
Provider Name (Legal Business Name): MICHELLE VALDES ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RICHARDS AVE APT 114
NORWALK CT
06854-1632
US

IV. Provider business mailing address

579 YETMAN AVE
STATEN ISLAND NY
10307-1827
US

V. Phone/Fax

Practice location:
  • Phone: 929-423-6606
  • Fax:
Mailing address:
  • Phone: 929-705-0108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND1314
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number775
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: