Active NPI
Antonio Manuel Valdez, CASAC
- Substance Abuse Rehabilitation Facility
- New York, NY
National Provider Identifier
1982972519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- License
- 19543
- Practice address
- 72 Seaman Ave
Apartment 4-H
New York, NY 10034-2822 - Phone
- (646) 964-5396
- Fax
- (646) 964-5396
- NPI assigned
- Dec 10, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | 19543 | NY | Primary |
Addresses
Primary practice location
72 Seaman Ave
Apartment 4-H
New York, NY 10034-2822
Mailing address
72 Seaman Ave
Apartment 4-H
New York, NY 10034-2822
Phone (646) 964-5396
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19543 | NY | MD | Substance Abuse Rehabilitation Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323475200000",
"number": "1982972519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 SEAMAN AVE",
"address_2": "APARTMENT 4-H",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100342822",
"telephone_number": "646-964-5396",
"fax_number": "646-964-5396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72 SEAMAN AVE",
"address_2": "APARTMENT 4-H",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100342822",
"telephone_number": "646-964-5396",
"fax_number": "646-964-5396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALDEZ",
"first_name": "ANTONIO",
"middle_name": "MANUEL",
"name_prefix": "Mr.",
"credential": "CASAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-10",
"last_updated": "2011-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "NY",
"license": "19543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.