Healthcare Provider Details

I. General information

NPI: 1255447751
Provider Name (Legal Business Name): ROBERT JAMES VALENTI PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 CROSS KEYS OFFICE PARK
FAIRPORT NY
14450-3506
US

IV. Provider business mailing address

38 KIRKBY TRAIL
FAIRPORT NY
14450
US

V. Phone/Fax

Practice location:
  • Phone: 585-797-5599
  • Fax:
Mailing address:
  • Phone: 585-797-5599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number010630
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number010630
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number010630
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number010630
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number010630
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: