Individual
LUCILA QUINTO VILLALUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
865 E 4TH ST, BETHLEHEM, PA 18015-1935
(670) 691-4357
(484) 221-9130
Mailing address
PO BOX 5349, BETHLEHEM, PA 18015-0349
(484) 221-9136
(484) 221-9130
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD055156-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001621278
—
PA
01
—
018606
AMERIHEALTH 65 COMPLETE
PA
01
—
G80233
MAGELLAN BEHAVIORAL HEALT
PA
Enumeration date
02/08/2007
Last updated
09/18/2015
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