Healthcare Provider Details

I. General information

NPI: 1598762122
Provider Name (Legal Business Name): DONNA M VALENTINI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 WASHINGTON ST SUITE 120
DEDHAM MA
02026-6731
US

IV. Provider business mailing address

980 WASHINGTON ST SUITE 120
DEDHAM MA
02026-6731
US

V. Phone/Fax

Practice location:
  • Phone: 781-251-2222
  • Fax: 781-234-0279
Mailing address:
  • Phone: 781-251-2222
  • Fax: 781-234-0279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3550
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: