Provider Demographics
NPI:1629015383
Name:VALOVSKI, IVAN T (MD)
Entity Type:Individual
Prefix:
First Name:IVAN
Middle Name:T
Last Name:VALOVSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3 MARIE PATH
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4172
Mailing Address - Country:US
Mailing Address - Phone:617-323-7700
Mailing Address - Fax:617-323-5777
Practice Address - Street 1:1400 VFW PKWY
Practice Address - Street 2:VA BOSTON HEALTH CARE SYSTEM
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-4927
Practice Address - Country:US
Practice Address - Phone:617-323-7700
Practice Address - Fax:617-323-5777
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA216372207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology