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General NPI Number Information
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NPI Number | 1194732495
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Entity Type | Individual
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Provider Name | MR. FREDERICK SCOTT VALENTE
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 22 TOMPKINS ST
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City | WATERBURY
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State | CT
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Zip | 06708-1417
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Country | US
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Telephone | 203-419-0381
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Fax | 203-419-0389
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Provider Business Mailing Address
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Address Line | 115 MARBERN LN
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City | NAUGATUCK
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State | CT
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Zip | 06770-1640
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Country | US
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Telephone | 203-729-2629
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 004477
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License Number State | CT
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