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General NPI Number Information
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NPI Number | 1295802247
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Entity Type | Individual
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Provider Name | PHYU P VALLEJO M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 301 SPRING GARDEN RD
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City | HAMMONTON
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State | NJ
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Zip | 08037-2516
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Country | US
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Telephone | 609-561-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 202 BARBARA LN
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City | FRANKLINVILLE
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State | NJ
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Zip | 08322-3855
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Country | US
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Telephone | 856-875-7399
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA06752800
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License Number State | NJ
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