Provider Demographics
NPI:1003968512
Name:MUOIO, VALERIE M (MD)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:M
Last Name:MUOIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 NORTHERN BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021
Mailing Address - Country:US
Mailing Address - Phone:516-622-5100
Mailing Address - Fax:516-622-5103
Practice Address - Street 1:865 NORTHERN BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021
Practice Address - Country:US
Practice Address - Phone:516-622-5100
Practice Address - Fax:516-622-5103
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164162207V00000X
NY164162-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01136236Medicaid
25F471Medicare ID - Type Unspecified
NY01136236Medicaid