Provider Demographics
NPI:1285624965
Name:WALENTIN, ROBERT W (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:WALENTIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1891 BILLINGSGATE CIR STE B
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23238-4242
Mailing Address - Country:US
Mailing Address - Phone:845-591-8099
Mailing Address - Fax:
Practice Address - Street 1:1891 BILLINGSGATE CIR STE B
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23238-4242
Practice Address - Country:US
Practice Address - Phone:845-591-8099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008156111N00000X
VA104001575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7140870OtherCIGNA
NY10071122OtherCDPHP
NY101226OtherLOCAL 825
NYX09Q61OtherEMPIRE BC/BS
NY0111208OtherGHI
NY514930OtherPHCS
NY84881OtherGHI HMO
NY917178OtherAETNA
NYC081564OtherWORKERS COMPENSATION
NY7140870OtherCIGNA
NY84881OtherGHI HMO