Provider Demographics
NPI:1144423674
Name:VALDEZ, ANDRES (MA)
Entity Type:Individual
Prefix:MR
First Name:ANDRES
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ABINGDON SQ
Mailing Address - Street 2:APT #3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-1875
Mailing Address - Country:US
Mailing Address - Phone:646-709-7490
Mailing Address - Fax:
Practice Address - Street 1:6002 ROOSEVELT AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3538
Practice Address - Country:US
Practice Address - Phone:718-943-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health