Individual
DANIEL VILLAVICENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1071 INMAN AVE UNIT 4, EDISON, NJ 08820-1132
(732) 518-8868
(732) 719-6080
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(888) 830-4125
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01999100
NJ
Other
Enumeration date
04/24/2021
Last updated
01/18/2022
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