Provider Demographics
NPI:1336494822
Name:VALLER, RINA
Entity Type:Individual
Prefix:
First Name:RINA
Middle Name:
Last Name:VALLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RINA
Other - Middle Name:
Other - Last Name:VALLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:719 MONTANA DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-4647
Mailing Address - Country:US
Mailing Address - Phone:908-770-2244
Mailing Address - Fax:732-909-2576
Practice Address - Street 1:719 MONTANA DR
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-4647
Practice Address - Country:US
Practice Address - Phone:908-770-2244
Practice Address - Fax:732-909-2576
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2410488174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist