Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC004329-L | PA |
N | 111N00000X | Chiropractor | DC004329L | PA |
NPI | 1003801531 |
---|---|
Provider Name | Dr. Viola A Agostino Valletta |
First Address | New Kensington, PA 15068 |
Second Address | New Kensington, PA 15068 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 22/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
605281 | BCBS (01) | PA |
U02151 | (02) | PA |