Provider Demographics
NPI:1003506197
Name:VALLEY MEDICAL CARE PC
Entity type:Organization
Organization Name:VALLEY MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHATTHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-532-6585
Mailing Address - Street 1:19 BLOSSOM ROW
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-2509
Mailing Address - Country:US
Mailing Address - Phone:718-532-6585
Mailing Address - Fax:
Practice Address - Street 1:1130 LINDEN ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2144
Practice Address - Country:US
Practice Address - Phone:516-320-8156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty