Organization Name: | VALLEY PHYSICIAN SERVICES, INC. |
NPI Number: | 1154470870 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARC GOLDSTEIN (PRESIDENT) |
Mailing Address: | 223 N Van Dien Ave Ridgewood |
State: | NJ US |
Postal Code: | 074502726 |
Phone Number: | 2014478517 |
Fax Number: | 2014478491 |
NPI Enumeration Date: | 01/10/2007 |
NPI Last Update Date: | 08/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |