Individual
MIRANDA VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., PA-C
Contact information
Practice address
901 W MAIN ST, CENTRASTATE MEDICAL CENTER, FREEHOLD, NJ 07728-2537
(732) 294-2666
(732) 431-8267
Mailing address
PO BOX 2680, CENTRAL JERSEY EMERGENCY MED ASSOC PC, NEW BRUNSWICK, NJ 08903-2680
(800) 666-2455
(610) 617-6280
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00177400
NJ
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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