Provider Demographics
NPI:1720199946
Name:VALENTINO, JERALYN J
Entity Type:Individual
Prefix:MS
First Name:JERALYN
Middle Name:J
Last Name:VALENTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 JULIAN ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-2713
Mailing Address - Country:US
Mailing Address - Phone:330-782-9140
Mailing Address - Fax:
Practice Address - Street 1:2817 JULIAN ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-2713
Practice Address - Country:US
Practice Address - Phone:330-782-9140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2304070Medicaid