Provider Demographics
NPI:1437208642
Name:VALLEY EAR, NOSE AND THROAT
Entity Type:Organization
Organization Name:VALLEY EAR, NOSE AND THROAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIGLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-245-7700
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10535-0215
Mailing Address - Country:US
Mailing Address - Phone:914-245-7700
Mailing Address - Fax:914-245-7836
Practice Address - Street 1:3630 HILL BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:JEFFERSON VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10535-1502
Practice Address - Country:US
Practice Address - Phone:914-245-7700
Practice Address - Fax:914-245-7836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165043207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWX1051Medicare UPIN