Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 25MA06428100 | NM |
NPI | 1023049558 |
---|---|
Provider Name | Dr. Rey Taneo Villanobos |
First Address | Monroe Township, NJ 08831-5150 |
Second Address | Somerset, NJ 08873-5036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 19/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H23306 | (02) | NJ |