Provider Demographics
NPI:1205387248
Name:VALENTE PROPERTIES LLC
Entity Type:Organization
Organization Name:VALENTE PROPERTIES LLC
Other - Org Name:WPT SPECIALTY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:VALENTE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:856-769-4564
Mailing Address - Street 1:84 E GRANT ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:WOODSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08098-1400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:84 E GRANT ST
Practice Address - Street 2:SUITE #2
Practice Address - City:WOODSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08098-1400
Practice Address - Country:US
Practice Address - Phone:856-769-4564
Practice Address - Fax:856-769-4637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
NJ40QA00312300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty