Healthcare Provider Details

I. General information

NPI: 1417310970
Provider Name (Legal Business Name): VALLEY MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 04/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 ESSEX RD
PARAMUS NJ
07652-1451
US

IV. Provider business mailing address

15 ESSEX RD
PARAMUS NJ
07652-1451
US

V. Phone/Fax

Practice location:
  • Phone: 201-291-6086
  • Fax: 201-291-6138
Mailing address:
  • Phone: 201-291-6086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARC GOLDSTEIN
Title or Position: PRESIDENT
Credential:
Phone: 201-291-6086