Individual
MR. BRYAN JOEL VILLANUEVA NITURAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
820 2ND AVE RM 6A, NEW YORK, NY 10017-4530
(929) 245-6596
Mailing address
3975 56TH ST APT 1J, WOODSIDE, NY 11377-8904
(929) 245-6596
(347) 332-1651
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
038911
NY
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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