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Individual
MR. TIMOTHY GERARD VALLES
Active
Individual
MR. TIMOTHY GERARD VALLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
015725
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03474742
—
NY
Enumeration date
07/11/2012
Last updated
08/28/2012
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