Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 142411 | NY |
N | 208600000X | Surgeon | 142411 | NY |
N | 2082S0105X | Plastic Hand Surgeon | 142411 | NY |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 142411 | NY |
NPI | 1336200898 |
---|---|
Provider Name | Dr. Fredrick Augustus Valauri |
First Address | New York, NY 10021-1730 |
Second Address | New York, NY 10075-1730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 15/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A97614 | (02) | NY |