Mr. Luis Antonio Caceres Villalta
Family Doctor - Adult Medicine
3716 108th St
Corona
, New York 11368-2025
Mr. Luis Antonio Caceres Villalta
Family Doctor - Adult Medicine
3716 108th St
Corona
, New York 11368-2025
(718) 651-4000
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Mr. Luis Antonio Caceres Villalta
- 3716 108th St
- Corona, NY
- Zip : 11368-2025
- Phone : (718) 651-4000
Second Address
- Mr. Luis Antonio Caceres Villalta
- 3716 108th St
- Corona, NY
- Zip : 11368-2025
- Phone : (718) 651-4000
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Is Mr. Luis Antonio Caceres Villalta a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | 310925-01 | NY |
National Provider Identifier
| NPI | 1053803742 |
|---|---|
| Provider Name | Mr. Luis Antonio Caceres Villalta |
| First Address | Corona, NY 11368-2025 |
| Second Address | Corona, NY 11368-2025 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/05/2018 |
| Last Update Date | 07/07/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.