Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 193639 | NY |
N | 111NI0900X | Internist | 193639 | NY |
N | 207RA0401X | Internist - Addiction Medicine | 193639-1 | NY |
NPI | 1881732840 |
---|---|
Provider Name | Dr. Judith Delvalle |
First Address | Elmhurst, NY 11373-1036 |
Second Address | Elmhurst, NY 11373-1036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 08/07/2007 |