Individual
BERNARDO R VILLAJUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
319 BROADWAY, FORT EDWARD, NY 12828-1221
(518) 761-0300
(518) 480-0119
Mailing address
9 CAREY RD, QUEENSBURY, NY 12804-7880
(518) 761-0300
(518) 824-2388
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
115492
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00366569
—
NY
Enumeration date
08/31/2006
Last updated
01/31/2017
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