Individual
JULIO VALDIVIESO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 HEALTHY WAY, OCEANSIDE, NY 11572-1551
(516) 632-3000
Mailing address
1 HEALTHY WAY, OCEANSIDE, NY 11572-1551
(516) 632-3000
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
187453
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02408597
—
NY
Enumeration date
10/07/2005
Last updated
07/08/2007
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