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Organization

MICHAEL VALALIK PMHNP BC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL VALALIK PMHNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
(203) 640-1563
Entity
Organization

Contact information

Practice address
770 SAYBROOK RD BLDG B, MIDDLETOWN, CT 06457-4739
(203) 640-1563
Mailing address
PO BOX 2486, MIDDLETOWN, CT 06457-0034
(203) 640-1563
(203) 774-1161

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6276
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1669841987
INDIVIDUAL NPI NUMBER
Enumeration date
10/28/2015
Last updated
08/26/2021
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