Healthcare Provider Details

I. General information

NPI: 1871167676
Provider Name (Legal Business Name): MARTHA VILLARIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 KINGS HWY N STE 7
CHERRY HILL NJ
08034-1535
US

IV. Provider business mailing address

600 KINGS HWY N
CHERRY HILL NJ
08034-1505
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 866-389-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01112800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP023407
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: