Provider Demographics
NPI:1013182906
Name:VALLEY SURGICAL SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:VALLEY SURGICAL SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIAD
Authorized Official - Middle Name:E
Authorized Official - Last Name:ABOUEZZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-452-5258
Mailing Address - Street 1:1 FIELD CT
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5208
Mailing Address - Country:US
Mailing Address - Phone:845-452-5258
Mailing Address - Fax:845-452-4530
Practice Address - Street 1:1 FIELD CT
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-5208
Practice Address - Country:US
Practice Address - Phone:845-452-5258
Practice Address - Fax:845-452-4530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210196208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG76621Medicare UPIN