Provider Demographics
NPI:1578605275
Name:VALINOTTI, RICHARD JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOHN
Last Name:VALINOTTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:164 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-3411
Mailing Address - Country:US
Mailing Address - Phone:631-273-7105
Mailing Address - Fax:631-273-7253
Practice Address - Street 1:160 4TH ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-4610
Practice Address - Country:US
Practice Address - Phone:631-273-7105
Practice Address - Fax:631-273-7253
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166479207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY95D081Medicare ID - Type Unspecified
NYA64979Medicare UPIN