MEDICARE: VALESKA THOMPSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ15417300	NJ

General Provider Information

NPI Number	:	1124963186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALESKA THOMPSON

Provider Business Mailing Address
First Line	:	634 EAGLE ROCK AVE
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-6800
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 TOWN CENTER WAY # 1148
Second Line	:
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-2978
Country	:	US
Telephone Number	:	973-494-4447
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2026
Last Update Date	:	04/23/2026

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Directions to “ VALESKA THOMPSON ” Practice Location

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