Villavicencio, Elizabeth

Villavicencio, Elizabeth is an individual health care provider with primary practice located at 347 Edison St , Staten Island NY 10306-3034. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Villavicencio, Elizabeth can be contacted via phone (718) 351-1136.

Contact Information

Primary practice address
347 Edison St Staten Island NY 10306-3034
Phone: (718) 351-1136
Fax: (718) 667-9711
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X F3814531 New York

Profile Details

NPI number 1790772010
LBN Legal business name Villavicencio, Elizabeth
Credentials NURSE PRACT
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2005
Last updated Nov 9th, 2012 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1790772010 NPPES
New York MEDICAID 02389417

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