William Valante

Individual provider Active NPI Prosthetic/Orthotic Supplier · River Vale, NJ

NPI 1942374152 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1942374152
Entity type
Individual (NPI type 1)
Primary specialty
Prosthetic/Orthotic Supplier 335E00000X
Practice address
Park Ridge Wig Center 669 Westwood Avenue
River Vale, NJ 07675
Phone
(201) 594-1123
Fax
(201) 594-0388
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Yes

Addresses

Primary practice location

Park Ridge Wig Center 669 Westwood Avenue
River Vale, NJ 07675

Mailing address

669 Westwood Avenue
Park Ridge Wig Center
River Vale, NJ 07675
Phone (201) 594-1123

Other identifiers

IdentifierTypeStateIssuer
G75521OtherNJEMPIRE BLUE CROSS
G75521OtherNYEMPIRE BLUE CROSS

Other providers in River Vale, NJ

All providers in River Vale, NJ · Prosthetic/Orthotic Supplier in New Jersey

Sources for this page

Verify at the official NPI Registry.