Provider Demographics
NPI:1861557118
Name:VALENTI, DENISE (OD)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:VALENTI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 MILK ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 GROSSMAN DR
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4997
Practice Address - Country:US
Practice Address - Phone:781-849-2295
Practice Address - Fax:781-849-2514
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3252152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW15699OtherBCBS
MA0014548OtherNHP
MA794894OtherTUFTS
MA0751857-002OtherCIGNA
MAE255OtherHPHC
MA0751857-002OtherCIGNA
MAE255OtherHPHC