Caceres Villalta, Luis Antonio

Caceres Villalta, Luis Antonio is an individual health care provider with primary practice located at 3716 108Th St , Corona NY 11368-2025. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as his primary health care specialty. Caceres Villalta, Luis Antonio can be contacted via phone (718) 651-4000.

Contact Information

Primary practice address
3716 108Th St Corona NY 11368-2025
Phone: (718) 651-4000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 310925-01 New York

Profile Details

NPI number 1053803742
LBN Legal business name Caceres Villalta, Luis Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2018
Last updated Jul 7th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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