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NPI Code Detail

MEDICARE: JULIO VALDIVIESO M.D.

MEDICARE: JULIO VALDIVIESO M.D.
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
12080N0001XNeonatal-Perinatal Medicine Physician187453NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306834080
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIO VALDIVIESO M.D.
Provider Business Mailing Address
First Line : 1 HEALTHY WAY
Second Line :
City : OCEANSIDE
State : NY
Zip : 11572-1551
Country : US
Telephone Number : 516-632-3000
Fax Number :
Provider Business Practice Location Address
First Line : 1 HEALTHY WAY
Second Line :
City : OCEANSIDE
State : NY
Zip : 11572-1551
Country : US
Telephone Number : 516-632-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 07/08/2007

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Directions to “ JULIO VALDIVIESO M.D.” Practice Location

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