Provider Demographics
NPI:1952437170
Name:VALENTE, MARK LOUIS (PT)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:LOUIS
Last Name:VALENTE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 MARLTON RD
Mailing Address - Street 2:
Mailing Address - City:PILESGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08098-2720
Mailing Address - Country:US
Mailing Address - Phone:856-769-0252
Mailing Address - Fax:856-769-8754
Practice Address - Street 1:172 MARLTON RD
Practice Address - Street 2:
Practice Address - City:PILESGROVE
Practice Address - State:NJ
Practice Address - Zip Code:08098-2720
Practice Address - Country:US
Practice Address - Phone:856-769-0252
Practice Address - Fax:856-769-8754
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA003123002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic