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General NPI Number Information
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NPI Number | 1538395314
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Entity Type | Organization
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Legal Business Name | VALLEY SPRING FAMILY MEDICINE PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/07/2009
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 3 FARRINGTON ST
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City | VAUXHALL
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State | NJ
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Zip | 07088-1307
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Country | US
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Telephone | 908-868-8904
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Fax | 973-762-4955
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Provider Business Mailing Address
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Address Line | 2040 MILLBURN AVE SUITE 205
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-3726
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Country | US
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Telephone | 973-762-4944
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Fax | 973-762-4955
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. KATHYANN SYLVIA DUNCAN
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Credential | M.D.
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Telephone | 973-762-4944
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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 | 25MA06382900
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License Number State | NJ
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