Healthcare Provider Details

I. General information

NPI: 1639280993
Provider Name (Legal Business Name): NICK VALENZE PHYSICAL THERAPIST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 FEURA BUSH RD
GLENMONT NY
12077-2983
US

IV. Provider business mailing address

365 FEURA BUSH RD
GLENMONT NY
12077-2983
US

V. Phone/Fax

Practice location:
  • Phone: 518-436-3954
  • Fax: 518-436-4257
Mailing address:
  • Phone: 518-436-3954
  • Fax: 518-436-4257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: NICK VALENZE
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT
Phone: 518-436-3954