Healthcare Provider Details

I. General information

NPI: 1700704939
Provider Name (Legal Business Name): DAVID VALENCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 BROAD ST STE 240
NEWARK NJ
07102-4417
US

IV. Provider business mailing address

7 ADELAIDE ST
BELLEVILLE NJ
07109-2221
US

V. Phone/Fax

Practice location:
  • Phone: 973-434-5081
  • Fax:
Mailing address:
  • Phone: 973-393-0549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: