Individual
DR. JOSE LICUANAN VILLALUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 W 86TH ST, SUITE # 507, NEW YORK, NY 10024-3666
(212) 873-0585
Mailing address
300 EAST 42ND STREET, APT. # 1505, NEW, NY 10021
(212) 873-0585
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
232191
NY
Other
Enumeration date
10/29/2006
Last updated
07/08/2007
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