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General NPI Number Information
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NPI Number | 1285678037
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Entity Type | Organization
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Legal Business Name | VALENTINE LANE FAMILY PRACTICE CENTER, INC.
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 503 S BROADWAY SUITE 210
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City | YONKERS
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State | NY
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Zip | 10705-3252
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Country | US
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Telephone | 914-965-9771
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Fax | 914-965-4724
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Provider Business Mailing Address
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Address Line | 503 S BROADWAY SUITE 210
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City | YONKERS
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State | NY
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Zip | 10705-3252
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Country | US
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Telephone | 914-965-9771
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Fax | 914-965-4724
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Authorized Official
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Title or Position | ASSISTANT EXECUTIVE DIRECTOR
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Name | KATHLEEN CALLANAN
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Credential | RN, MSN, CNAA
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Telephone | 914-964-7433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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