Individual
VALMORE JOSEPH SUPRENANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 NICOLLS ROAD, HSC LEVEL 4; ROOM 120, STONY BROOK, NY 11794-8460
(631) 444-5400
(631) 444-7538
Mailing address
HSC LEVEL 4, ROOM 120, STONY BROOK, NY 11794-8460
(631) 444-5400
(631) 444-7538
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MT186105
PA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
256500
NY
Other
Enumeration date
03/08/2010
Last updated
04/20/2022
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