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NPI Code Detail

MEDICARE: VALETA REVELLA DUNN LPN

MEDICARE: VALETA REVELLA DUNN LPN
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
1163WG0000XGeneral Practice Registered Nurse601269-1NY
2164W00000XLicensed Practical Nurse238-077-1NY

General Provider Information

NPI Number : 1740435544
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALETA REVELLA DUNN LPN
Provider Business Mailing Address
First Line : 218 TIMON ST
Second Line :
City : BUFFALO
State : NY
Zip : 14208-2437
Country : US
Telephone Number : 716-828-5472
Fax Number :
Provider Business Practice Location Address
First Line : 10 SYMPHONY CIR
Second Line :
City : BUFFALO
State : NY
Zip : 14201-1339
Country : US
Telephone Number : 716-884-7223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2008
Last Update Date : 11/20/2008

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Directions to “ VALETA REVELLA DUNN LPN” Practice Location

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