Provider Demographics
NPI:1851362024
Name:VALENZE, NICK E (PT)
Entity Type:Individual
Prefix:MR
First Name:NICK
Middle Name:E
Last Name:VALENZE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 FEURA BUSH RD & 9W
Mailing Address - Street 2:
Mailing Address - City:GLENMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12077-2983
Mailing Address - Country:US
Mailing Address - Phone:518-436-3954
Mailing Address - Fax:518-436-4257
Practice Address - Street 1:365 FEURA BUSH RD & 9W
Practice Address - Street 2:
Practice Address - City:GLENMONT
Practice Address - State:NY
Practice Address - Zip Code:12077-2983
Practice Address - Country:US
Practice Address - Phone:518-436-3954
Practice Address - Fax:518-436-4257
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0100441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
10002083OtherCAPITAL DISTRICT PHYSICIA
6602081OtherGHI
Q7304B/CATQ730OtherEMPIRE BCBS
P1112510OtherOXFORD
131891OtherWELLCARE
43524OtherMVP
5554529OtherAETNA US HEALTHCARE
43524OtherMVP