Organization Active NPI

Valentine Lane Family Practice Center, Inc.

  • Family Medicine Physician
  • Yonkers, NY
National Provider Identifier
1285678037
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VALENTINE LANE FAMILY PRACTICE CENTER, INC.
Practice address
503 S Broadway
Suite 210
Yonkers, NY 10705-3252
Phone
(914) 965-9771
Fax
(914) 965-4724
NPI assigned
Jun 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Authorized official

Name
Kathleen Callanan, RN, MSN, CNAA
Title
Assistant Executive Director
Phone
(914) 964-7433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

503 S Broadway
Suite 210
Yonkers, NY 10705-3252

Mailing address

503 S Broadway
Suite 210
Yonkers, NY 10705-3252
Phone (914) 965-9771

Other identifiers 1

IdentifierTypeStateIssuer
00473065MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1285678037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 S BROADWAY",
            "address_2": "SUITE 210",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107053252",
            "telephone_number": "914-965-9771",
            "fax_number": "914-965-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 S BROADWAY",
            "address_2": "SUITE 210",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107053252",
            "telephone_number": "914-965-9771",
            "fax_number": "914-965-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALENTINE LANE FAMILY PRACTICE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "CALLANAN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "ASSISTANT EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "914-964-7433",
        "authorized_official_credential": "RN, MSN, CNAA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473065",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.