Healthcare Provider Details

I. General information

NPI: 1306110408
Provider Name (Legal Business Name): THERESA CHRISTINE HUK-VALLARINO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2012
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9516 89TH AVE
WOODHAVEN NY
11421-2267
US

IV. Provider business mailing address

9516 89TH AVE
WOODHAVEN NY
11421-2267
US

V. Phone/Fax

Practice location:
  • Phone: 718-441-2165
  • Fax:
Mailing address:
  • Phone: 718-441-2165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number0126051
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: