Basic Information
| Provider Information | |||||||||
| NPI: | 1881727154 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VALLEY MEDICAL ASSOCIATES, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 135 DIVISION ST | ||||||||
| Address2: | |||||||||
| City: | ANSONIA | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064012134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037359354 | ||||||||
| FaxNumber: | 2037322106 | ||||||||
| Practice Location | |||||||||
| Address1: | 135 DIVISION ST | ||||||||
| Address2: | |||||||||
| City: | ANSONIA | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064012134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037359354 | ||||||||
| FaxNumber: | 2037322106 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 12/23/2014 | ||||||||
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| AuthorizedOfficialLastName: | MOSES | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE-PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2037359354 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 028004 | CT | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RR0500X | 020100 | CT | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RE0101X | 016432 | CT | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.