Valdemar NP in Psychiatry PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

VALDEMAR NP IN PSYCHIATRY PLLC

Practice address

1241 Deer Park Ave Ste 1
North Babylon, NY 11703-3114

Phone

(631) 241-2568

NPI assigned

Jun 26, 2024

Last updated

Jun 26, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Reggie Donald ValdemarNPI 1285374660

Title

Phmnp

Phone

(631) 241-2568

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Reggie Donald Valdemar, PHMNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ronkonkoma, NY
  • NPI 1285374660
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1225873870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 DEER PARK AVE STE 1",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 DEER PARK AVE STE 1",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033114",
            "telephone_number": "631-241-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALDEMAR NP IN PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "VALDEMAR",
        "authorized_official_first_name": "REGGIE",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "PHMNP",
        "authorized_official_telephone_number": "631-241-2568"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Tsourapa
• Ebonie Karma Tudor
• Danny Amit Tulsie, O.D.
• Joseph Turano, RPH
• Dorcas Sumawang Valcin, RN
• Christopher Ventura, NP
• Sandra J Victor
• Walgreen Co (Rite Aid)
• Sharon Elise Weidberg, SEIT
• Amy Wenz

• Clinic/Center in North Babylon, NY
• Providers in North Babylon, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.