Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 1028 | VI |
Y | 207P00000X | Emergency Physician | 25MA09027700 | NJ |
NPI | 1003925850 |
---|---|
Provider Name | Dr. Norma I. Villanueva |
First Address | Flemington, NJ 08822-4603 |
Second Address | Flemington, NJ 08822-4603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 02/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C77218 | (02) | VI |