Provider Demographics
NPI:1407802648
Name:VALENTI, LARAIN (DC)
Entity Type:Individual
Prefix:DR
First Name:LARAIN
Middle Name:
Last Name:VALENTI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3008
Mailing Address - Country:US
Mailing Address - Phone:516-731-0712
Mailing Address - Fax:516-934-0788
Practice Address - Street 1:361 BROADWAY
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-3008
Practice Address - Country:US
Practice Address - Phone:516-731-0712
Practice Address - Fax:516-934-0788
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010838111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X7M701Medicare PIN
V02032Medicare UPIN