Provider Demographics
NPI:1598130296
Name:VALDEZ, JOYCE (LPN)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 345
Mailing Address - Street 2:80 WINTISH ROAD
Mailing Address - City:ELLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12428-0345
Mailing Address - Country:US
Mailing Address - Phone:845-647-6084
Mailing Address - Fax:
Practice Address - Street 1:80 WINTISH ROAD
Practice Address - Street 2:
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428
Practice Address - Country:US
Practice Address - Phone:845-647-6084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299410164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse