Organization
LIEZL VILLAVERDE, MD PC
Active
Parent organization
LIEZL VILLAVERDE, MD PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIEZL VILLAVERDE, MD PC
Authorized official
MRS. LIEZL VILLAVERDE MD (PRESIDENT)
(718) 698-7220
Entity
Organization
Contact information
Practice address
105 BYRNE AVE, STATEN ISLAND, NY 10314
(718) 698-7220
(718) 698-2004
Mailing address
105 BYRNE AVE, STATEN ISLAND, NY 10314
(718) 689-7220
(718) 698-2004
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
210729
NY
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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