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NPI Code Detail

MEDICARE: MR. PAUL M VALLERA PA-C

MEDICARE: MR. PAUL M VALLERA PA-C
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
1363A00000XPhysician AssistantPA00240RI

General Provider Information

NPI Number : 1750318457
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL M VALLERA PA-C
Provider Business Mailing Address
First Line : 1210 BOSTON PROVIDENCE TPKE
Second Line :
City : NORWOOD
State : MA
Zip : 02062-5061
Country : US
Telephone Number : 781-255-0500
Fax Number : 781-255-0400
Provider Business Practice Location Address
First Line : 103 PROVIDENCE HWY
Second Line :
City : EAST WALPOLE
State : MA
Zip : 02032-1512
Country : US
Telephone Number : 781-255-0500
Fax Number : 781-255-0400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 04/20/2026

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