Individual
MR. PETER JOSEPH VALASTRO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
37 EVERTS AVE, QUEENSBURY, NY 12804-2040
(518) 793-4700
(518) 793-6325
Mailing address
PO BOX 4705, QUEENSBURY, NY 12804-0705
(518) 245-3837
(518) 899-4930
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
704435
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
403526
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F403526-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06428115
—
NY
Enumeration date
02/11/2020
Last updated
03/07/2022
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