Provider Demographics
NPI:1417336660
Name:VALENTIN, SAVANNAH LEIGH
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:LEIGH
Last Name:VALENTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SKINNER LN
Mailing Address - Street 2:APT 3C
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1546
Mailing Address - Country:US
Mailing Address - Phone:347-733-7328
Mailing Address - Fax:
Practice Address - Street 1:25 SKINNER LN
Practice Address - Street 2:APT 3C
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1546
Practice Address - Country:US
Practice Address - Phone:347-733-7328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319419-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse