Individual
MR. JORDAN JAMES VALLESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3424 KOSSUTH AVENUE, ROOM 9C - 01, BRONX, NY 10467
(718) 519-3972
Mailing address
3424 KOSSUTH AVE, BRONX, NY 10467-2410
(718) 519-3972
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
013839
NY
Other
Enumeration date
01/27/2010
Last updated
01/27/2010
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