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General NPI Number Information
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NPI Number | 1548184575
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Entity Type | Individual
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Provider Name | VIRGILIO LOPEZ VALENCIA RN
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Gender | Male
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 12510 QUEENS BLVD STE 4&5
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City | KEW GARDENS
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State | NY
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Zip | 11415-1519
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Country | US
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Telephone | 718-459-5582
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Fax | 718-459-6047
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Provider Business Mailing Address
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Address Line | 8360 VIETOR AVE APT 1C
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City | ELMHURST
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State | NY
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Zip | 11373-3248
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Country | US
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Telephone | 718-459-5592
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Fax | 718-459-6047
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 669707
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License Number State | NY
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