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General NPI Number Information
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NPI Number | 1538252168
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Entity Type | Individual
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Provider Name | PABLO VILLEGAS MD
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 EAST 125TH STREET WARDS ISLAND
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City | NEW YORK
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State | NY
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Zip | 10035
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Country | US
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Telephone | 646-672-6212
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Fax | 646-672-6538
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Provider Business Mailing Address
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Address Line | 1755 YORK AVENUE APT 15D
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City | NEW YORK
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State | NY
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Zip | 10128
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Country | US
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Telephone | 212-996-7331
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 221125-1
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License Number State | NY
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