Provider Demographics
NPI:1073691242
Name:D. JOEL VALENTINI
Entity Type:Organization
Organization Name:D. JOEL VALENTINI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:D.
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:VALENTINI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:518-272-0881
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12181-0455
Mailing Address - Country:US
Mailing Address - Phone:518-272-0881
Mailing Address - Fax:518-272-0965
Practice Address - Street 1:500 FEDERAL ST STE 601
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2832
Practice Address - Country:US
Practice Address - Phone:518-272-0881
Practice Address - Fax:518-279-7413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002776-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00414613Medicaid
NYP00409335OtherRAILROAD MEDICARE NUMBER
NYBA1074Medicare PIN
NY5898310001Medicare NSC
NYP00409335OtherRAILROAD MEDICARE NUMBER