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General NPI Number Information
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NPI Number | 1518217736
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Entity Type | Individual
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Provider Name | EDWIN VALENTIN LMSW
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Gender | Male
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 10/01/2012
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Provider Practice Location Address
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Address Line | 9114 37TH AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7920
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Country | US
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Telephone | 718-779-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 125 TEN EYCK ST APT 4D
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City | BROOKLYN
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State | NY
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Zip | 11206-1254
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Country | US
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Telephone | 347-512-0268
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 087064
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License Number State | NY
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