Individual
LESLIE V VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
92 SUMMIT AVE, HACKENSACK, NJ 07601-1263
(201) 342-0066
Mailing address
389 WESTMINSTER PL, LODI, NJ 07644-1218
(201) 663-1203
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
2600396800
NJ
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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