MEDICARE: DR. GERARDO VILLARUZ ESTEVEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	25MA05968800	NJ
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	25MA05968800	NJ

General Provider Information

NPI Number	:	1659379865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERARDO VILLARUZ ESTEVEZ MD

Provider Business Mailing Address
First Line	:	1931 OAK TREE RD
Second Line	:	SUITE 201
City	:	EDISON
State	:	NJ
Zip	:	08820-2072
Country	:	US
Telephone Number	:	732-452-0680
Fax Number	:	732-452-9136

Provider Business Practice Location Address
First Line	:	1931 OAK TREE RD
Second Line	:	SUITE 201
City	:	EDISON
State	:	NJ
Zip	:	08820-2072
Country	:	US
Telephone Number	:	732-452-0680
Fax Number	:	732-452-9136

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	04/11/2024

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