Provider Demographics
NPI:1922139377
Name:OVERTON, VALARIE (MD)
Entity Type:Individual
Prefix:
First Name:VALARIE
Middle Name:
Last Name:OVERTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 WHITE PLAINS RD
Mailing Address - Street 2:STE 224
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-725-5556
Mailing Address - Fax:914-725-5597
Practice Address - Street 1:688 WHITE PLAINS RD
Practice Address - Street 2:STE 224
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:914-725-5556
Practice Address - Fax:914-725-5597
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162489207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00969255Medicaid
NY00969255Medicaid
A64189Medicare UPIN