Provider Demographics
NPI:1851790828
Name:VALDEVILLA, ASUNCION
Entity Type:Individual
Prefix:MRS
First Name:ASUNCION
Middle Name:
Last Name:VALDEVILLA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ASUNCION
Other - Middle Name:
Other - Last Name:VALDEVILLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1347 E 94TH ST
Mailing Address - Street 2:1347 E 94TH ST.
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4803
Mailing Address - Country:US
Mailing Address - Phone:347-275-3968
Mailing Address - Fax:
Practice Address - Street 1:1347 E 94TH ST
Practice Address - Street 2:1347 E 94TH ST.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4803
Practice Address - Country:US
Practice Address - Phone:347-275-3968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY575112-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse