Provider Demographics
NPI:1972037778
Name:STEVEN J VALENTINO DO PC
Entity Type:Organization
Organization Name:STEVEN J VALENTINO DO PC
Other - Org Name:LIBERTY SPINE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NIRALI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:908-370-9104
Mailing Address - Street 1:375 E ELM ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1973
Mailing Address - Country:US
Mailing Address - Phone:908-370-9104
Mailing Address - Fax:484-212-7641
Practice Address - Street 1:700 S HENDERSON RD
Practice Address - Street 2:SUITE 110
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3530
Practice Address - Country:US
Practice Address - Phone:610-265-5795
Practice Address - Fax:610-992-9022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005197L332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site