Provider Demographics
NPI:1366706814
Name:VALENTINE, MURIEL (MSED)
Entity type:Individual
Prefix:
First Name:MURIEL
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MADISON AVE APT 416
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-2730
Mailing Address - Country:US
Mailing Address - Phone:212-534-7496
Mailing Address - Fax:
Practice Address - Street 1:1901 MADISON AVE APT 416
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2730
Practice Address - Country:US
Practice Address - Phone:212-534-7496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist