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General NPI Number Information
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NPI Number | 1346686516
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Entity Type | Organization
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Legal Business Name | REY T. VILLANOBOS MD, LLC
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Dates
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Enumeration Date | 05/15/2013
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 9 CLYDE RD STE 102
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City | SOMERSET
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State | NJ
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Zip | 08873-5036
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Country | US
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Telephone | 732-828-2030
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Fax | 732-828-2043
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Provider Business Mailing Address
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Address Line | 36 MUIRFIELD BLVD
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City | MONROE TOWNSHIP
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State | NJ
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Zip | 08831-5150
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Country | US
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Telephone | 732-828-2030
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Fax | 732-828-2043
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. REY TANEO VILLANOBOS
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Credential | MD
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Telephone | 732-828-2030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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