Provider Demographics
NPI:1396984829
Name:VALERA, MAGALYS M (LAC, CA)
Entity type:Individual
Prefix:MS
First Name:MAGALYS
Middle Name:M
Last Name:VALERA
Suffix:
Gender:F
Credentials:LAC, CA
Other - Prefix:MS
Other - First Name:MAGALYS
Other - Middle Name:M
Other - Last Name:VALERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, CA
Mailing Address - Street 1:1631 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1605
Mailing Address - Country:US
Mailing Address - Phone:908-322-2803
Mailing Address - Fax:908-322-2804
Practice Address - Street 1:1631 E 2ND ST
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1605
Practice Address - Country:US
Practice Address - Phone:908-322-2803
Practice Address - Fax:908-322-2804
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00051200171100000X
NY003353171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist