Provider Demographics
NPI:1093821720
Name:STORIE, VALERIE M (PT)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:M
Last Name:STORIE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:77 W BARNEY ST
Mailing Address - Street 2:GOUVERNEUR HOSPITAL
Mailing Address - City:GOUVERNEUR
Mailing Address - State:NY
Mailing Address - Zip Code:13642-1040
Mailing Address - Country:US
Mailing Address - Phone:315-535-9317
Mailing Address - Fax:315-535-9318
Practice Address - Street 1:77 W BARNEY ST
Practice Address - Street 2:GOUVERNEUR HOSPITAL
Practice Address - City:GOUVERNEUR
Practice Address - State:NY
Practice Address - Zip Code:13642-1040
Practice Address - Country:US
Practice Address - Phone:315-535-9317
Practice Address - Fax:315-535-9318
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0226811174400000X
NY022681-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist