Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Vallerie Gabriella Djojoseparto, PA-C

Individual provider Medical Physician Assistant · NPI 1073836151

Vallerie Gabriella Djojoseparto, PA-C is a Medical Physician Assistant in Forest Hills, New York. Licensed in New York. Registered with an NPI since 2010.

Licensed in
NY
In the registry since
2010
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

11420 Queens Blvd
Forest Hills, NY 11375-7056
Phone: (718) 459-8460
Fax: (718) 459-8464
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 013551 (NY)

Record details

NPI number1073836151
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 3, 2010
Last updated in NPPESMarch 3, 2010

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