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General NPI Number Information
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NPI Number | 1033269378
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Entity Type | Organization
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Legal Business Name | VALLEY SPINE SPECIALISTS, PC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 695 E 16TH ST SUITE F
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City | BERWICK
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State | PA
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Zip | 18603-2320
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Country | US
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Telephone | 570-802-0360
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Fax | 570-802-0363
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Provider Business Mailing Address
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Address Line | PO BOX 384
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City | BERWICK
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State | PA
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Zip | 18603-0384
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Country | US
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Telephone | 570-802-0360
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Fax | 570-802-0363
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Authorized Official
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Title or Position | PROPRIETOR
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Name | GERARD J FOTI
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Credential | D.O
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Telephone | 570-802-0360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | OS 009073L
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License Number State | PA
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