Provider Demographics
NPI:1265492623
Name:VALENTINI, DINO JOEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:DINO
Middle Name:JOEL
Last Name:VALENTINI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:D. JOEL
Other - Middle Name:
Other - Last Name:VALENTINI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12181-0455
Mailing Address - Country:US
Mailing Address - Phone:518-272-0881
Mailing Address - Fax:518-272-0965
Practice Address - Street 1:500 FEDERAL ST
Practice Address - Street 2:SUITE 601
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2867
Practice Address - Country:US
Practice Address - Phone:518-272-0881
Practice Address - Fax:518-272-0965
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002776-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA1074OtherMEDICARE GROUP #
NY00414613Medicaid
NY5898310001OtherMEDICARE DME
NY5898310001OtherMEDICARE DME
NYBA1074OtherMEDICARE GROUP #
NY00414613Medicaid