Valhalla Medics, LLC

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

Legal business name

VALHALLA MEDICS, LLC

Practice address

92-18 Rockaway Beach Blvd
Rockaway Beach, NY 11693

Phone

(516) 266-6186

Fax

(445) 800-8689

NPI assigned

Mar 17, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Philip D'Agostino

Title

Ceo

Phone

(516) 266-6186

Specialties & licenses 4

Addresses

Other names 1

• Nature Freak Lifestyle, LLC Former legal business name

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1720736705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92-18 ROCKAWAY BEACH BLVD",
            "city": "ROCKAWAY BEACH",
            "state": "NY",
            "postal_code": "11693",
            "telephone_number": "516-266-6186",
            "fax_number": "445-800-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92-18 ROCKAWAY BEACH BLVD",
            "city": "ROCKAWAY BEACH",
            "state": "NY",
            "postal_code": "11693",
            "telephone_number": "516-266-6186",
            "fax_number": "445-800-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALHALLA MEDICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "D'AGOSTINO",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "516-266-6186",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medical Technician, Basic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247ZC0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nature Freak Lifestyle, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Basic Emergency Medical Technician in Rockaway Beach, NY
• Providers in Rockaway Beach, NY by specialty
• Basic Emergency Medical Technician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.