Provider Demographics
NPI:1194272799
Name:DELLAVALLE, JOSEPH MICHAEL (DPT)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:DELLAVALLE
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14151-0366
Mailing Address - Country:US
Mailing Address - Phone:716-402-4920
Mailing Address - Fax:716-322-5505
Practice Address - Street 1:1275 MAIN ST STE 120
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-1911
Practice Address - Country:US
Practice Address - Phone:716-402-4920
Practice Address - Fax:716-322-5505
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040430225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist