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General NPI Number Information
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NPI Number | 1619075652
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Entity Type | Organization
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Legal Business Name | VALLEY DIAGNOSTIC MEDICAL CENTER
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 470 N FRANKLIN TPKE STE 203
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City | RAMSEY
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State | NJ
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Zip | 07446-1385
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Country | US
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Telephone | 201-327-0500
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Fax | 201-327-8612
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Provider Business Mailing Address
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Address Line | 470 N FRANKLIN TPKE STE 203
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City | RAMSEY
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State | NJ
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Zip | 07446-1385
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Country | US
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Telephone | 201-327-0500
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Fax | 201-327-8612
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Authorized Official
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Title or Position | PARTNER
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Name | RICHARD LUCANIE
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Credential | M.D.
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Telephone | 201-327-0500
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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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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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