Provider Demographics
NPI:1366420838
Name:VALLA, SUNEEL S (MD)
Entity type:Individual
Prefix:MR
First Name:SUNEEL
Middle Name:S
Last Name:VALLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SUNEEL
Other - Middle Name:
Other - Last Name:VALLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:244 COBBLESTONE LN
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-8912
Mailing Address - Country:US
Mailing Address - Phone:610-252-9053
Mailing Address - Fax:610-252-9021
Practice Address - Street 1:50 S 18TH ST UNIT 2
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3912
Practice Address - Country:US
Practice Address - Phone:610-252-9053
Practice Address - Fax:610-252-9021
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD416989207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0690227OtherCIGNA HEALTHCARE
PA999699OtherHIGHMARK BLUE SHIELD
PA3232062OtherAETNA US HEALTHCARE PPO
PA50004102OtherCAPITAL BC
PA0018692900011Medicaid
PAN76739OtherAMERIHEALTH ADMINISTRATOR
PA20025803OtherAMERIHEALTH MERCY
PA67587OtherGEISINGER HEALTH
PA817653OtherFIRST PRIORITY HEALTH
PA7342302OtherAETNA US HEALTHCARE HMO
PA1526263OtherGATEWAY HEALTH PLAN
PA1942250634OtherGROUP NPI
PA5996219OtherGHI
PAP2749181OtherOXFORD HEALTH
PAH43314Medicare UPIN
PAN76739OtherAMERIHEALTH ADMINISTRATOR
PA0018692900011Medicaid
PA057718Medicare PIN