Individual
JULIE LAVALLIERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9000
Mailing address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
321839-01
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
321839-01
NY
Other
Enumeration date
04/15/2020
Last updated
02/19/2025
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