Healthcare Provider Details

I. General information

NPI: 1730083403
Provider Name (Legal Business Name): DR. DUTLEY ANGELO VALNEUS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 WALKER ST
BROOKLYN NY
11239-5736
US

IV. Provider business mailing address

716 WALKER ST
BROOKLYN NY
11239-5736
US

V. Phone/Fax

Practice location:
  • Phone: 347-469-9348
  • Fax:
Mailing address:
  • Phone: 347-469-9348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number056444
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: