Provider Demographics
NPI:1720032592
Name:VALVEZAN, ROSE N (AUD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:N
Last Name:VALVEZAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 TULIP LN
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-2515
Mailing Address - Country:US
Mailing Address - Phone:516-221-7870
Mailing Address - Fax:
Practice Address - Street 1:HOFSTRA UNIVERSITY
Practice Address - Street 2:SPEECH LANGUAGE HEARING CLINIC, 131 HOFSTRA
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11549-0001
Practice Address - Country:US
Practice Address - Phone:516-463-5603
Practice Address - Fax:516-463-4831
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000762-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM22711Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER