Healthcare Provider Details

I. General information

NPI: 1205387248
Provider Name (Legal Business Name): VALENTE PROPERTIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 E GRANT ST SUITE #2
WOODSTOWN NJ
08098-1400
US

IV. Provider business mailing address

84 E GRANT ST SUITE #2
WOODSTOWN NJ
08098-1400
US

V. Phone/Fax

Practice location:
  • Phone: 856-769-4564
  • Fax: 856-769-4637
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00312300
License Number StateNJ

VIII. Authorized Official

Name: MARK L VALENTE
Title or Position: OWNER
Credential: PT
Phone: 856-769-4564