Provider Demographics
NPI:1073782181
Name:VALLEY CARE, INC.
Entity Type:Organization
Organization Name:VALLEY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:
Authorized Official - First Name:AKBER
Authorized Official - Middle Name:H
Authorized Official - Last Name:HASSAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-762-5252
Mailing Address - Street 1:2 FONCLAIR TERRACE EXT.
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095-3100
Mailing Address - Country:US
Mailing Address - Phone:518-762-5252
Mailing Address - Fax:
Practice Address - Street 1:2 FONCLAIR TERRACE EXT.
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095-3100
Practice Address - Country:US
Practice Address - Phone:518-762-5252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RC0000X
NY1527701207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00842517Medicaid
NYBA1364Medicare UPIN