1366420838 NPI number — MR. SUNEEL S VALLA MD

Table of content: MR. SUNEEL S VALLA MD (NPI 1366420838)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366420838 NPI number — MR. SUNEEL S VALLA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VALLA
Provider First Name:
SUNEEL
Provider Middle Name:
S
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VALLA
Provider Other First Name:
SUNEEL
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1366420838
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/24/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
244 COBBLESTONE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18020-8912
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-252-9053
Provider Business Mailing Address Fax Number:
610-252-9021

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 S 18TH ST UNIT 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EASTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18042-3912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-252-9053
Provider Business Practice Location Address Fax Number:
610-252-9021
Provider Enumeration Date:
01/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RS0012X , with the licence number:  MD416989 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0690227 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 999699 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3232062 . This is a "AETNA US HEALTHCARE PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50004102 . This is a "CAPITAL BC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0018692900011 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: N76739 . This is a "AMERIHEALTH ADMINISTRATOR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 20025803 . This is a "AMERIHEALTH MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 67587 . This is a "GEISINGER HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 817653 . This is a "FIRST PRIORITY HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7342302 . This is a "AETNA US HEALTHCARE HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1526263 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1942250634 . This is a "GROUP NPI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5996219 . This is a "GHI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P2749181 . This is a "OXFORD HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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