Individual
JAMES A DELLAVALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
33-57 HARRISON ST, JOHNSON CITY, NY 13790-2107
(607) 763-6412
(607) 763-5854
Mailing address
346 GRAND AVE, JOHNSON CITY, NY 13790-2580
(607) 763-6412
(607) 763-5854
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
158928
NY
207Q00000X
Family Medicine Physician
158928
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00750789
—
NY
Enumeration date
10/04/2005
Last updated
05/23/2022
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