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General NPI Number Information
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NPI Number | 1659071918
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Entity Type | Organization
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Legal Business Name | VALENCIA HEALTH MEDICAL PC
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 10857 ROOSEVELT AVE # STO
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City | CORONA
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State | NY
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Zip | 11368-5630
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Country | US
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Telephone | 929-244-5771
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Fax |
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Provider Business Mailing Address
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Address Line | 3230 156TH ST
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City | FLUSHING
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State | NY
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Zip | 11354-3326
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Country | US
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Telephone | 929-244-5771
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Fax |
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | JONATHAN VALENCIA
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Credential | MD
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Telephone | 929-244-5771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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