Provider Demographics
NPI:1336200898
Name:VALAURI, FREDRICK AUGUSTUS (MD FACS)
Entity Type:Individual
Prefix:DR
First Name:FREDRICK
Middle Name:AUGUSTUS
Last Name:VALAURI
Suffix:
Gender:M
Credentials:MD FACS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:47 E 77TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-1730
Mailing Address - Country:US
Mailing Address - Phone:212-439-0080
Mailing Address - Fax:
Practice Address - Street 1:47 EAST 77TH STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1730
Practice Address - Country:US
Practice Address - Phone:212-439-0080
Practice Address - Fax:212-472-8907
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142411208200000X, 2082S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY13-3583343OtherEIN
NYA97614Medicare UPIN