Individual
MISS THELMA VILLAR FADERAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 WATERSIDE PLZ, 23C, NEW YORK, NY 10010-2622
(212) 725-2923
(212) 725-2923
Mailing address
30 WATERSIDE PLAZA, 23C, NEW YORK, NY 10010-2625
(212) 725-2923
(212) 725-2923
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
5186830
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5186830
NP LICENSE NUMBER
NY
Enumeration date
05/17/2007
Last updated
07/08/2007
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