Provider Demographics
NPI:1881727154
Name:VALLEY MEDICAL ASSOCIATES, P.C.
Entity type:Organization
Organization Name:VALLEY MEDICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-735-9354
Mailing Address - Street 1:135 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-2134
Mailing Address - Country:US
Mailing Address - Phone:203-735-9354
Mailing Address - Fax:203-732-2106
Practice Address - Street 1:135 DIVISION ST
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-2134
Practice Address - Country:US
Practice Address - Phone:203-735-9354
Practice Address - Fax:203-732-2106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028004207RG0100X
CT020100207RR0500X
CT016432207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D80847Medicare UPIN
CTB37630Medicare UPIN
CTB38712Medicare UPIN