Provider Demographics
NPI:1073597001
Name:VALLARIO, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:VALLARIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CHERRY HILL RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1113
Mailing Address - Country:US
Mailing Address - Phone:973-299-1400
Mailing Address - Fax:973-299-9011
Practice Address - Street 1:50 CHERRY HILL RD
Practice Address - Street 2:SUITE 204
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1113
Practice Address - Country:US
Practice Address - Phone:973-299-1400
Practice Address - Fax:973-299-9011
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA38076207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1383400Medicaid
NJ1383400Medicaid
NJC63245Medicare UPIN