Provider Demographics
NPI:1396028767
Name:VALDES MONTEMAYOR, GUILLERMO (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:GUILLERMO
Middle Name:
Last Name:VALDES MONTEMAYOR
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:DR
Other - First Name:GUILLERMO
Other - Middle Name:
Other - Last Name:VALDES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MBA
Mailing Address - Street 1:180 WEST END AVENUE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:917-789-1422
Mailing Address - Fax:917-464-9897
Practice Address - Street 1:180 WEST END AVENUE
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:917-789-1422
Practice Address - Fax:917-464-9897
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2806562084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry