Provider Demographics
NPI:1306829379
Name:VALDELLON, ALEJANDRO MONTANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:MONTANA
Last Name:VALDELLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7717 STUYVESANT AVE.
Mailing Address - Street 2:P.O. BOX 7717
Mailing Address - City:WEST TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08628
Mailing Address - Country:US
Mailing Address - Phone:609-633-6351
Mailing Address - Fax:609-292-3241
Practice Address - Street 1:7717 STUYVESANT AVE.
Practice Address - Street 2:
Practice Address - City:WEST TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08628
Practice Address - Country:US
Practice Address - Phone:609-633-6351
Practice Address - Fax:609-292-3241
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO38860174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist