Individual
EDWARD VILLALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
717 FRONT ST, HEMPSTEAD, NY 11550-4534
(516) 609-3100
(516) 609-0671
Mailing address
717 FRONT ST, HEMPSTEAD, NY 11550-4534
(516) 609-3100
(516) 609-0671
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
012840
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012840
LICENCE
NY
Enumeration date
07/13/2016
Last updated
07/13/2016
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