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General NPI Number Information
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NPI Number | 1053462523
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Entity Type | Individual
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Provider Name | MARIA ELENA VILLAVIEJA RN,FNP
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 506 MALCOLM X BLVD NEW NURSES RESIDENCE RM 409
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City | NEW YORK
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State | NY
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Zip | 10037-1802
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Country | US
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Telephone | 212-939-4330
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Fax |
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Provider Business Mailing Address
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Address Line | 49 JORDAN AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07306-3215
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Country | US
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Telephone | 201-779-9075
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F333668-1
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License Number State | NY
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