Individual
ANDREA MARTINEZ VILLALOBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
159 CARLETON AVE, CENTRAL ISLIP, NY 11722-4172
(631) 650-2510
(631) 650-0497
Mailing address
9033 ELMHURST AVE, JACKSON HEIGHTS, NY 11372-7935
(718) 457-7000
(718) 899-4955
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
018884
NY
363AM0700X
Medical Physician Assistant
018884
NY
Other
Enumeration date
11/13/2015
Last updated
02/10/2021
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