Provider Demographics
NPI:1659158871
Name:VALDUEZA, CRISTETA MAGNO (AGPCNP)
Entity Type:Individual
Prefix:PROF
First Name:CRISTETA
Middle Name:MAGNO
Last Name:VALDUEZA
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 PLAINFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2134
Mailing Address - Country:US
Mailing Address - Phone:516-328-2841
Mailing Address - Fax:
Practice Address - Street 1:27111 76TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1423
Practice Address - Country:US
Practice Address - Phone:718-289-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF309913-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health