Provider Demographics
NPI:1184860280
Name:DIEUDONNE PUNTIEL, VALINE REBECCA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:VALINE
Middle Name:REBECCA
Last Name:DIEUDONNE PUNTIEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 WEST 14TH STREET-BUSINESS HEALTH
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:212-420-2882
Mailing Address - Fax:
Practice Address - Street 1:226 WEST 14TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-420-2882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-20
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0127591363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant