Provider Demographics
NPI:1184880981
Name:DREZALIU, VALENTIN FLORINEL (MD)
Entity type:Individual
Prefix:
First Name:VALENTIN
Middle Name:FLORINEL
Last Name:DREZALIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 W 93RD CT
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-1719
Mailing Address - Country:US
Mailing Address - Phone:929-444-2296
Mailing Address - Fax:
Practice Address - Street 1:607 W 93RD CT
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-1719
Practice Address - Country:US
Practice Address - Phone:929-444-2296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116018094207V00000X
IN01068660A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200999760Medicaid
IN000000684947OtherANTHEM
INM400028029Medicare PIN
INM55843011Medicare PIN